Right To Die
Job 3:20A federal judge ruled that the Constitution does not contain a so-called "right to die."
Article on next page details how a California initiative that would allow doctors to give lethal injections, failed.
Euthanasia in Christian preaching challenges the sanctity of life, emphasizing that life is a sacred gift from God that should not be prematurely ended by human hands (Deuteronomy 30:19). Illustrations often use stark images of comas, ethical controversies, and cultural shifts toward death to highlight the dangers of embracing a 'culture of death' over divine sovereignty (Psalm 139:13-16).
A federal judge ruled that the Constitution does not contain a so-called "right to die."
Article on next page details how a California initiative that would allow doctors to give lethal injections, failed.
Recent biography on Freud delves into his character. Freud born in 1856 in Vienna, worshipped by his mom, though he exiled mothers to the margins of his case histories (a striking symptom of the limitations in his theories about women generally). "Freud the conventional bourgeois battled Freud the scientific conquistador every step of the way." Liked to trash his opponents, could not allow his disciples to grow up. Attached to his daughter Anna, psychoanalyzed her against his own strictures. She never married. Mrs. Freud played an "astonishingly small role in his life."
Freud, dying of cancer in 1939, arranged to commit suicide with the help of a trusted physician friend. This secret act of euthanasia researcher Peter Gay sees as one final testament to Freud's essential character: "The old stoic had kept control of his life to the end." Gay portrays a creative titan at war with his inner demons. Sometimes of course the demons carried the day.
#203
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Story about example of euthanasia - it shocks us, but in short order the act may become unquestionable. Public debate leads to public acceptance. Another example is homosexuality.
Peter Rosier, a successful Florida pathologist, and his wife Patricia plotted her death. She had lung cancer. She took sleeping pills, which did not work. He then gave her a double dose of morphine. But her stepfather, Vincent Delman, confessed that that did not work either, so he smothered her with a pillow.
Hemlock Society advocates freedom to do this, and argues doctors do it all the time to help patients rest "comfortably." Rosier has no doubts about what he did. "[Her] decision to end her own life had to do with minimizing the pain to those around her, and, perhaps, to herself. I merely helped her on her way." Florida now has two out of the three Americans in jail for mercy killing.
Carrie Coons, 86, was in a vegetative coma. Relatives wanted her unplugged because she had expressed a desire to die. But she began to speak and would not commit herself to having the feeding tubes removed. Her answer - it would be a difficult decision.
Dr. Jack Kevorkian "doesn't have a doctor-patient relationship with these people. He's not there for treatment or diagnosis. He doesn't give them alternatives or reasons to live. He's there to help you die," says ethicist George Annas of Boston University. Each victim has been a woman. (Details given on each case.)
#2125
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Sermon for Sanctity Sunday, 1993.
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CHOOSE LIFE
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I. The certainty of life and death.
A. Life and death issues are at the cutting edge of our society.
B. From extraordinary measures, to ordinary, to none, to positive
action to destroy unwanted life.
II. How much is your life worth?
A. We all have some basic worth.
B. World says we are worthwhile due to what we produce or experience.
C. Bible says we are valuable because made makes us so. Luke 12:24
III. When does life start?
A. The frontiers of science.
B. Dilemma of abortion faces this question head on.
IV. When does our life end?
A. Most families will face this question intimately.
B. The definition of death. Hebrews 9:27
C. Promoting death, providing life, or prolonging death?
V. Choose life. Deut 30:15ff
A. Life must be given the preference.
B. How long have you lived? REALLY lived? John 10:10
#2417
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The first death in the Bible came as a "solution" to a problem. The sons of Adam and Eve quarreled and Cain "resolved" it by slaying his brother Abel. Death is still used today as a final solution. In thought and deed.
A decision is not agreed with and angry yells erupt: "Kill the umpire!" Property or life is threatened and someone shouts: "Shoot 'em!" A failing body suffers in an intensive care ward and a relative whispers: "Pull the plug!"
One nation feels threatened by another and a soldier says: "Nuke 'em!" An egregious crime is committed and an outraged community shouts: "Give him the chair!" or "String em up!"
Are we getting too cozy with death? Too chummy with the Grim Reaper? Death was the worldly solution to Jesus: "Crucify him! Crucify him!" Easter is the heavenly answer: "Vivit! Vivit! He lives! He lives!"
#2443
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Princeton hires a pro-death ethicist vilified by the rest of the world.
Australian ethicist Peter Singer at least minces no words when he argues that the disabled and the unwanted should be killed. Not just passive euthanasia, but active, eugenic euthanasia for infants, the sick, and the elderly- everyone, to use his words, whose "life is not worth living."
No wonder he is so controversial in Europe and his home country that his speaking appearances are accompanied by angry protests from those he thinks are better off dead and those who care about them. In Austria, a major philosophy conference had to be canceled due to protests and threats from disabled groups. In Germany, he is compared to Hitler's theorist Martin Bormann. In Australia, he has been called the country's "most notorious messenger of death." Wherever Mr. Singer speaks, protesters in wheelchairs chain themselves to the barricades that have to be erected around his lecture sites.
In the United States, however, Mr. Singer is given an endowed chair at Princeton University. He has just been appointed to the Ira W. DeCamp Professorship of Bioethics at the University Center for Human Values. This is a prestigious position at one of America's most prestigious universities, joining a faculty that once included Jonathan Edwards and J. Gresham Machen.
British philosopher David S. Oderberg reported in The Washington Times the significance of this particular appointment. According to Mr. Oderberg's summary of his thought, Mr. Singer believes that since infants are not "rational and self-aware," they should not be considered human until they are at least one month old. Up to that time, they could be killed. Newborn babies have, to use his analogy, the same moral value as snails. As "non- persons," they are "replaceable," much like chickens and other farm animals. That is, if parents chose infanticide for a "defective" child, say, with hemophilia, and later gave birth to a healthy baby, the total amount of happiness would be greater and thus their act would be moral.
Mr. Singer's ethical theory seems to be based on a curious quasi-mathematical attempt to calculate the sum total of human happiness that would result from a particular decision or policy. On this basis, he claims to be able to show not only that voluntary euthanasia (such as physician-assisted suicide) and non-voluntary euthanasia (for the mentally incapacitated who cannot decide for themselves) are morally justified. He also believes that involuntary euthanasia for anyone who has become a burden to society is a moral act.
Not only is Mr. Singer purportedly an expert in bioethics; he is a major theorist for the animal-rights movement, the author of Animal Liberation and Animal Rights and Human Obligations. Although he defends animals, strictly speaking, he does not believe in "rights" (as in "human rights") at all: He dismisses them as "a convenient political shorthand" with no basis in any kind of divine or natural objective moral order. Nevertheless, it is ironic that while Mr. Singer equates the life of a newborn baby with that of a snail, he would be likely to urge that the snail not be mistreated.
Not that Mr. Singer isn't qualified to be a bioethics professor at Princeton, at least according to the prevailing academic standards. Research content seldom sparks controversy-unless it leans in conservative directions. What counts more in American academia is the amount and the "importance" of one's publications. The online bookstore Amazon.com lists 38 books published by Mr. Singer. These include, significantly, a number of introductory overviews and edited collections of readings used as college textbooks.
Universities responding to the call for "values education" and liberal arts colleges trying to replace their old theology requirements are now instead requiring a course in "ethics." Very likely, they are using Mr. Singer's textbooks.
America is having to wrestle more and more with ethical dilemmas, especially those posed by the new medical technologies. Since religious teachings are ruled out of bounds by policymakers, our country is turning to secular experts for guidance on moral issues. Hospitals set up "ethics boards"; bureaucrats hire consultants to draw up policies; and universities such as Princeton establish a Center for Human Values and bring on recognized authorities such as Mr. Singer.
The mere invocation of "ethics" may do more harm than good, serving as a process of rationalizing what is actually profoundly unethical. The value of "ethics" depends on the worldview upon which they are founded.
There was a time when Christians and non-Christians alike could agree that certain moral truths are "self-evident," that human beings have been "endowed by their Creator with certain unalienable rights." Today, with the very concept of a Creator jettisoned by the intellectual establishment, these truths are not self-evident at all, but in fact are coming under harsh attack.
In today's thinking, rights are endowed not by God but by the culture-or even the government. And what the culture or government sees fit to endow, it can also take away.
Contemporary Americans turn instinctively to the academic establishment whenever they need "expert" advice, but secularist academicians may be the very worst people to turn to today for moral expertise. They are the most likely to hold the postmodernist myth that culture creates values. And since the academic subculture gives more status and more endowed chairs to those who are "progressive" (advocating cultural evolution) and "cutting edge" in their fields (advocating ideas that are radically new), the kind of moral advice that will emanate from our halls of learning is easily predictable.
There are major exceptions, of course, such as Mr. Oderberg, who teaches at the University of Reading in England. His critiques of Mr. Singer exemplify the service academics should be rendering. But those looking for an expert on the intractable moral issues of our day would do better simply to ask a pastor or another leader who has studied the Bible, believes in it, and can apply it in a sophisticated way.
Preparing such experts used to be the mission of Princeton University. Now it endows a Center for Human Values that decenters human values. Now it hires an ethicist who dismantles ethics, whose teachings if put into practice would establish, as Hitler never could, a culture of murder.
[see also #4680]
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New Princeton ethicist holds shocking views, but no one should be surprised by his appointment
By the time you read this column, Peter Singer will have assumed his new position as the Ira B. DeCamp professor of bioethics at the University Center for Human Values, Princeton University. Around the country, many people have been shocked by his appointment. I'm not.
Don't misunderstand: The honor paid Mr. Singer by Princeton soils every scholar everywhere. This is the man who says newborn babies are replaceable- his term; the man who says that they have no more value than snails-his comparison; the one who thinks people who burden society should be murdered- but he calls it "involuntary euthanasia." As he explains, the fact that a being is human is "not relevant to the wrongness of killing it."
But why should anyone be shocked? The universities have been nourishing such abominations for years.
Once at an academic convention I was the designated "respondent" to a talk by another scholar about ethics. First he criticized theistic religions for being "biased" in favor of God. Next he criticized Enlightenment thinkers for having been "biased" in favor of man. Rejecting "bias," he proposed equal respect for all living things.
This was my question: "I am driving in my automobile. A little girl darts into the road from the right, and at the same moment two dogs dart into the road from the left. Should I swerve to the right to miss the dogs and hit the girl? After all, they have equal rights, and there are two of them and only one of her."
His reply? "I admit that there are some unresolved problems in eco-centric ethics."
In the early 1980s a young nihilist interviewed for a position at my own university. His lecture maintained that human beings just make up the difference between good and evil, and that nobody is responsible for what he does anyway. Within a short time he was in the classroom, teaching the young. The reason I remember that case is that the young nihilist was me.
No one found fault with my views until a few years later, after my conversion, when I had realized that good and evil are real and not made up. I landed in the soup when I opposed the hiring of someone much like my former self, a scholar who held that logical reasoning is obsolete. For this I was attacked as "intolerant," and the applicant was hired-only to be snapped up by another university a few years later, to head up a prestigious scholarly institute.
Now put all these examples together. The "eco-ethicist" found the question of killing too difficult to answer. Peter Singer believes killing the helpless is right. I used to believe right cannot be distinguished from wrong. Finally, the nihilist after me believed true cannot be distinguished from false. The first two views make sane ethical thinking impossible; the third makes ethical thinking impossible; and the fourth makes thinking impossible. Yet all these views are welcomed on the modern campus.
The only thing unwelcome is opposing them. New York Times reporter Katherine Zoepf quotes the president of the student Bioethics Forum, expressing surprise that the Singer appointment has aroused protests: "I never thought Princeton could react like this." A molecular biology teacher remarks, "I think it's a brilliant appointment. I don't know any professor at the university who's against it." He continues, "I think there's been some amusement at the reactions this has been getting, the attacks from both the far right and the far left."
Yes, how amusing that anyone would think that ethics is about protecting the weak and the helpless, instead of getting them out of the way.
But Princeton has merely acted as most universities do today. The big question is what to do about them. There is no point hoping for them to change themselves, for they are already changing themselves-in the wrong direction. Nor can we expect outside pressure to change them, because in a culture of death, most of the pressure is for them to stay on their present course.
Christians both inside and outside the universities must think hard about what it means to bear witness today: to love God not only with all our hearts and with all our strength, but with all our minds. Two generations ago, one could be excused for considering "the life of the mind" just a figure of speech. Today it is plain that the integrity of the intellect is truly a matter of life and death.
[see also #4679]
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God surprises us in dark places.
One of the saddest essays I have ever read appeared in the New Yorker in May 1995, written by a young man, Andrew Solomon, who was coming to terms with his mother’s death. She had been battling cancer -- and lost. The week she was diagnosed with it, she announced that she was going to kill herself.
And she did, less than two years later. She picked the day (June 19, 1991) and the outfit (her nightgown with pink roses), and following the step-by-step instructions published in “Let Me Die Before I Wake” (“a less explicit precursor of Derek Humphrey’s Final Exit”), she began the preliminary steps for “self-deliverance.” She took the antiemetics followed with a light snack. The Hemlock Society recommends having a plastic bag (and a taut rubber band) on hand as well. Step 11 of a manual published by ergo! (the Euthanasia Research and Guidance Organization, started by Humphrey when he left the Hemlock Society in 1992) suggests that, in the event the pills don’t do it: “Place the plastic bag (or bags) over the head and draw the elastic bands over the bag, securing it firmly around the adam’s apple area. There must be no leaks.”
After tea and an English muffin, Mrs. Solomon nestled into her bed, and, as her family gathered around her, she spilled some 40 Seconal tablets onto her bedspread, scooped them, and like a “virtuoso” swallowed them all, “two or three at a time.”
“Surely this is better than your seeing me screaming in a hospital bed,” she said. For the subsequent 45 minutes of her final moments of consciousness, she said all those things that a wife and mother longs to say. And she said this: “I’m sad today. I’m sad to be going... .”
Her son wrote in retrospect: “Euthanasia is a legitimate way to die, and at its best it is full of dignity. But it is still suicide, and suicide is the saddest thing in the world.” He concluded, “How we die is, in fact, the least of it.... But when we die -- this is a powerful business.”
My father, like Mrs. Solomon, also had cancer and began his rapid decline last August. We thought the prostate cancer had been eradicated two years earlier when he had undergone surgery. In fact, my family and I were far more concerned about his other health problems -- emphysema and heart fibrillations. My father heroically battled through each day as these ailments conspired against him. So it took my sisters, my brother, my mother, and me by surprise when it became clear that the cancer, not the spasmodic heart or damaged lungs, would be the death of him.
In mid-August he posted this, his last E-mail message, addressed to my husband:
Date: Aug 15, 1995
Subj.: The Power of Prayer
Dear Bob: your prayers must have done it. Last nite i couldnt get in or out of bed without help. at 5 i woke up in wet sheets that were soaked from sweat. my pain was relieved almost entirely. it wont stay away but this is ok. thank you for your prayers. love, dad.
We did pray -- all the time -- for my dad. We didn’t know how to pray or what to pray for, but we rejoiced with him that day when his pain melted away into a bundle of wet sheets. But I knew, as my father did, that despite all the prayers in heaven and on earth, his pain would come back.
And it did. But in the course of these last weeks of his life, my father made a choice in the same way Mrs. Solomon made her choice. Apart from the bright yellow “Do Not Resuscitate” orders pasted indecorously on his bedroom wall for any and all to see, my father surrendered his dying into the hands of God, and we did, too.
The idea of “physician-assisted suicide” never entered his mind. So we waited and watched as he slowly left us: he stopped coming out to the kitchen table for meals; he stopped sitting up in his bed for meals; then he stopped eating altogether; then he stopped drinking. We saw him move from emotional connection to this life into quiescent assurance of his eternal destination, which gave way to paranoiac agitation, which gave way to delirium, to incoherence, and finally, silence.
He suffered. And we suffered, too. But neither he, nor we, took back that choice to let God have his way in this death, even when the pain and sense of powerlessness were so acute that we pondered the strangeness of God’s way of doing things.
Mrs. Solomon’s son explains in his essay that her intention to kill herself did not arise out of the desire to alleviate her symptoms (“she scarcely had any symptoms”). But rather, it was her way of “expressing a sense of outrage at the indignity of what lay ahead and a profound fear of losing control of her own life.” He said, “It was as though she wanted vengeance for the snub she had received from nature: if her life could not be as exquisite as it had been, she would have no more of it.... ‘I’m already dead,’ she said as she lay in her hospital bed. ‘What’s here for you to love?’ “
There are indignities that are inherent in the dying process, Mrs. Solomon is right about that. As the body weakens, functions that were once automatic suddenly become heroic. It is natural to want to avoid being reduced to these painfully humiliating exercises.
[Author talks about the humiliation her Christian father went through...]
If you have never tried it or helped someone else through it, you cannot begin to imagine how difficult it is to kill yourself,” wrote Andrew Solomon. But he adds, “We were among the lucky ones; we did not have to resort to plastic bags, or to watch my mother vomit over herself. It was that ideal death which plays out in Hemlock Society publications: the gentle, easeful death.”
After Mrs. Solomon had lapsed into unconsciousness, it came down to Andrew and his brother and father checking in intermittently to see if she was still breathing. “Her breathing sometimes seemed slower, but it was hard to tell,” he writes. “The discipline of not doing is usually more difficult than the discipline of doing, and of all the not I have confronted, the most painful was the not waking my mother as she slid by slow degrees from sleep to death.... In that room with her, I maintained a kind of empty silence, and wondered what stage of dying she had reached.”
There was no turning back for the Solomons. Mrs. Solomon had made her choice.
“Just after midnight,” he continues, “my brother, the most restrained and most reasonable of us, went to check and found that the breathing had stopped.”
It took five hours, from the moment Mrs. Solomon scooped up and swallowed the pills to the moment when her heart beat for the last time.
My father’s joyful acquiescence in response to his heavenly vision was interrupted when his pain management moved to a new level. He could no longer tolerate the pain with Vicodan only. It was time to introduce MS Contin -- morphine. By the end of the first week of the new drug, my father’s behavior was dramatically altered. He woke up in the middle of the night another time, this time panic-stricken that he did not have enough oxygen. He wanted to call 911, which we as family had all agreed not to do under any circumstances, since, presumably, they would be compelled to begin heroic life-preserving measures -- probably by putting him on a respirator -- which contradicted his own desires. (We would call hospice instead, in the event of an emergency.) My bedridden, frail father, who under normal circumstances at this stage couldn’t brush his own teeth, wrestled my poor mother for the phone and dialed 911.
Despite all apprehensions, my mother sang praises for the arrival of the paramedics, who immediately sedated my father (and, thankfully, didn’t put him on a respirator).
“The diagnosis is clear,” wrote my brother-in-law (a doctor) over the Internet the next day to all the family. “Delirium.”
He said that the disorientation and hallucinations, the “waxing and waning sensorium,” were the classic hallmarks of delirium. He said adjusting medication and “maintaining oxygenation” will help, but that some degree of delirium would probably continue. “There will be times of relative lucidity, though these times will be fewer and farther between as time goes on.”
There was no turning back. My father had made his choice.
One of the last devotions I had shared with my father comforted him and me, too: “He will swallow up death in victory; and the Lord God will wipe away tears from off all faces -- there shall be no more death, neither sorrow, nor crying, neither shall there be any more pain.”
A friend of Andrew Solomon’s, who had also “assisted” in a loved one’s suicide, told him, “It is a relationship that is not natural ... you scar forever.” But Solomon still concluded that in the light of the “simple logic of euthanasia in action,” with its “comfort and control,” it “astonished” him “how many people die by other means.”
The “other means” had the better of my father. We could not choose the day of his dying -- my plane reservations missed it by two days. And he had no clue what outfit he had on. There were moments when we all cried, and even laughed (what else could we do?) at what had become of this once unstoppable force of personality. We were cutting his T-shirts up the back at the end, to get them off and on him.
Euthanasia is logical, if comfort and control and a certain kind of “dignity” -- the hallmark of the American psyche -- form the defining paradigm of life. But when we seize that kind of control we are reduced to the outermost limits of human imaginings, which does not promise much.
Understandably, it is scary to relinquish control -- it takes us places where we may not want to go, like bedroom floors, on our knees, crawling around, groping for oxygen. But God comes to us in those places. In fact, more often than not in those places is where he resides, and sometimes it takes our going there to find him. He surprises us there: he may take us to an imaginary dock to pull in the boat -- or he may take us to the outskirts of heaven! Sometimes it is only in the dark places where our eyes can see him for who he is.
We are still left to wonder why death must be preceded by so many twists and turns before finally having its way with us. But in all the wondering, when we surrender how we die into the hands of the One who gave us life, we are freed from the limitation of human definitions of dignity, and worthiness, and beauty, and quality of life.
At one of the many crises we experienced in my father’s decline, I felt utterly helpless, powerless, and cut off (living a thousand miles away did not help). I wrote in my journal this prayer: What can I give him now? It is only You he needs -- only You can meet him where he is right now. That he would see You, even in the midst of his pain, that he could behold Your beauty in these dark moments, that is my deepest prayer for him now.
The Lord answered those prayers, in ways I did not expect or was prepared for. My father was right when he wrote that last E-mail to my husband: There is power in prayer. And my father’s assurance of that spoke prophetically about what would be required of us all to get through this passage. There is power, but not control.
Mrs. Solomon’s death and her son’s grief carry all the sadness that a human breast can bear. My father’s death does, too. Andrew Solomon is right: When we die is “a powerful business.” But still, most of us, despite the conveniences of euthanasia, do not make that choice.
But how we die -- “the least of it,” in Solomon’s words -- makes all the difference in my mind. For the “night is far spent, the day is at hand” and when we awake we shall “be satisfied with thy likeness.” How we die, with all its anguish, can be like “the light of the morning ... even a morning without clouds.”
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Copyright (c) 1996 Christianity Today, Inc./CHRISTIANITY TODAY Magazine, Volume 40, No. 4, page 34
An urban legend from South Africa has patients mysteriously dying. A cleaning woman is implicated when it is found she unplugs their respirators so she can plug in her floor polisher. (It is untrue, and has several parallel stories.)
Jewish scholars debating the acceptability of taking people off life support and allowing them to die naturally. The broadly accepted view is that, while one is not obliged to place someone on life support and can allow them to die naturally if there is little hope of saving them, the picture changes once someone is actually on life support. According to the argument, it is unacceptable for any human being to cut off the life support machine - intentionally - regardless of how hopeless the situation may be, since a decision to end a life may only be taken by God. However, and this is exactly as it was put to Goldstuck by one scholar, should "a cleaner accidentally unplug the machine to plug in a cleaning machine, you are not obliged to switch the machine back on again."
A television station in Oregon recently began airing a new how-to video. This one won't help you to install a bathroom sink or prepare a gourmet meal, however. No, this new instructional guide is about suicide, and how to get it right on your first try.
In 1991, Derek Humphrey, a founder of the Hemlock Society, published a best-selling suicide manual called Final Exit. Along with justifications for the act of suicide, the author identified the most lethal drugs, and offered tips on how to obtain them without a doctor's prescription. He even described how to mix a fatal dose in an easy-to-swallow concoction.
Now, in its newly released video format, "Final Exit, the movie," goes even further. Although Humphrey claims his advice is only for "self-deliverance of the terminally ill," he and the TV producers in Oregon are making it available to everyone -- for the terminally ill as well as for those who may have just had a bad day. And let's remember, researchers tell us that as many as twenty percent of Americans suffer from some form of depression.
Station managers claim they want to enable people "to make the hard decisions in their lives." But the truth is, people suffering from physical or mental anguish are the least able to make those decisions without intervention. As Pamela Cavallo, of the National MS Society puts it, "Many people who say they want to hasten death really want help with living." But sometimes they can't tell the difference.
Airing this kind of programming sends a powerful and destructive message, telling people that suicide is okay. Critics and advocates alike believe it will increase the number of suicides in that state. Portland psychiatrist Gregory Hamilton says, "For people ... on the edge, it pushes them over."
Suicide was the eighth leading cause of death in the United States in 1997. Among young people 15 to 24, the suicide rate doubled in the last decade. Fortunately, most suicide attempts are unsuccessful. But television advocacy will likely make suicide attempts not only more frequent, but much more successful. What started out as an impulsive act, or as a desperate cry for help, may now lead to irreversible tragedy.
What we need to see is that this is where the slippery slope of Roe V. Wade has brought us, with its easy acceptance of the culture of death. Not only have we become insensitive to the deaths of millions of unborn babies, but, more and more, we've ceased to value our own lives.
The answer to suffering, of course, is not death - it's care and compassion. Now, the law can't provide that, but it can encourage it. Right now, Congress is considering the Pain Relief Promotion Act. This important new legislation promotes palliative care to relieve the suffering of the terminally ill and bans the use of federally funded drugs in doctor- assisted suicide. We need to support these kinds of initiatives.
And you need to be prepared to speak out if you see that your local cable station may be thinking about airing this dangerous video. As Christians, we must also remember our calling to comfort the afflicted in a world that turns so quickly to despair. We need to be ready always to share Christ's love with those in need of hope and healing.
___________________
Copyright (c) 2000 Prison Fellowship Ministries. Reprinted with permission. "BreakPoint with Chuck Colson" is a radio ministry of Prison Fellowship Ministries.
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With all the talk about health care, Medicare, managed care and all other sorts of care associated with the practice of medicine, surprisingly little is heard about the type of care likely to be most valuable for the baby boomers as they age: palliative care.
“Palliative care” is distinct from traditional medical care in that the latter often focuses on CURING at the expense of all else — meaning that patients deemed incurable may be neglected.
Palliative care, by contrast, focuses on CARING for the patient, seeking primarily to relieve pain and provide comfort. Its approach to sickness is broader: It treats the emotional, psychological and even spiritual dimensions of illness, not just the physical. This fuller approach alone can relieve much of the suffering that comes with serious illness.
In theory, palliative care enjoys widespread support from both medical professionals and those who formulate health-care policy. In practice, however, the application of palliative care principles is woefully lacking. Indeed, despite the advances in anesthesiology and the growth of the hospice movement, patients in this country continue to die in needless pain.
As Gregory Hamilton, president of the organization Physicians for Compassionate Care, recently testified, “Many, if not most, physicians and healthcare professionals remain unaware of the high success rate of recent advances in the use of pain relieving drug regimens and procedures for control of severe pain in the seriously ill." Mr. Hamilton described the magnitude of the problem nationwide as “staggering.”
What’s more, medical students report that there are very few classes on end-of-life care and pain relief. “That’s handled in the ethics classes,” remarked one resident.
The focus on curing certainly explains part of this phenomenon. But both pharmacists and doctors also report that prescribing the amount of drugs needed to relieve pain is risky business: Storing or prescribing large quantities of morphine can raise the eyebrows of federal drug authorities. This is so even though most professionals in the field of pain and symptom management recognize the need for high doses of controlled substances in some cases. Such doses are acceptable even when they hasten death, provided the purpose is solely to relieve pain or otherwise provide comfort to the patient.
Morphine, for example, has a number of effects: Pain control is one, but respiration depression (the slowing of breathing) is another. When doctors administer morphine to relieve pain, they practice sound medicine. When they administer it to stop the patient’s breathing with the intent of causing death, they do not. In medical circles, this is known as the principle of “double effect." The morally and legally relevant question is always: What was the doctor’s intent and purpose? Killing pain is fine; killing patients is not.
While the medical profession recognizes and appreciates this distinction, practically speaking, no one wants the hassle of an investigation by the Drug Enforcement Agency, much less the risk of sanction, license suspension, or even license revocation, should someone take issue with prescription quantities. Thus, doses remain low and inadequate for many patients in pain.
Meanwhile, stories of pain and discomfort, especially in the end stages of life, fuel the euthanasia movement. The more painful and unpleasant death appears, the more sympathy euthanasia proponents can elicit for the quick “out” supposedly provided by assisted suicide. Their advocacy of an “easy death” implies that the sole alternative is a hard death, an alternative that makes their position look reasonable and humane.
The choice between hard and easy dying is false, however. While death will inevitably be frightening to many, it does not have to be painful or inhumane. America has the option of committing resources toward this goal. But neither health-care policy nor the medical profession has made that commitment to date.
That is about to change.
On June 17, Sen. Don Nickles (R-Okla.) and Reps. Henry Hyde (R-Ill.) and Bart Stupak (D-Mich.) introduced the Pain Relief Promotion Act of 1999. With this legislation, the federal government is taking affirmative and aggressive steps to improve pain management and palliative care for patients in pain, particularly the terminally ill and those suffering from progressive and far advanced diseases.
The bill creates a program within the Agency for Health Care Policy and Research (AHCPR) to develop and advance scientific understanding of palliative care. It requires the Agency to collect and distribute pain management information to health-care programs, medical schools, and hospices, as well as the general public. It creates education and training programs for local, state and federal personnel (including DEA officers) regarding the proper use of controlled substances in pain management, including the administration of drugs that may hasten death, provided the purpose is pain relief.
While the bill encourages the legitimate use of controlled substances for relieving pain, it rejects their deliberate use for killing patients. This may disgruntle euthanasia proponents in Oregon (the only jurisdiction to allow the killing of some patients as part of medical care), but the bill merely clarifies and continues a century-long federal drug policy. Federal law regulates drug usage that “endangers public health and safety." That includes lethal overdoses as well as drug addiction. Citizens in Oregon may have decided to change the Oregon criminal code to allow lethal overdoses, but they cannot unilaterally change federal drug laws.
Fortunately for patients in pain, federal drug policy will now encourage the use of controlled substances for pain relief, but continue to disallow illegitimate purposes, such as killing. Those within Oregon intent on practicing assisted suicide, however, will need to find a way other than the illicit use of federally regulated drugs.
Most importantly, however, federal lawmakers appear to understand the ultimate contradiction between caring for patients and killing them. Killing is the antithesis of caring, notwithstanding the rhetoric of rights and compassion of the euthanasia movement. “Assisted suicide” for the dying is simply the killing of those most in need of care.
To care or to kill? That is the question. And palliative care, as advanced by the Pain Relief Promotion Act, is the answer.
***
TERESA R. WAGNER IS A POLICY ANALYST FOR LIFE ISSUES AT FAMILY RESEARCH COUNCIL AND AUTHOR OF FRC’S NEW BOOKLET "To Care or to Kill?"
*
It was a relatively calm day in my hospital's NICU (Neonatal Intensive Care Unit). Two other nurses and I were trying to have a conversation amid the customary sounds of ventilators and heart monitors. I was in mid-sentence when the shrill ring of the red emergency phone halted all conversation. "Come fast," the voice said urgently. "We need a neonatal nurse stat!"
Fear gripped my heart as I ran into the delivery room. Instantly, I knew the situation was critical. "What's happening here?" I asked.
"It's an 'oops abortion,' and now it's your problem!" responded one of the nurses. For us, an "oops abortion" meant the mother's due date was miscalculated, and the fetus survived the abortion procedure. A pediatrician was called to the scene. He ran by me with the fetus (now called a baby) in his hand and yelled in my direction, indicating he wanted me to follow him into the resuscitation room adjoining the delivery room. I looked into the bed of the warmer as I grabbed equipment. Before my eyes was a baby boy. A very, very tiny baby boy. The doctor and I immediately made an attempt at intubation (inserting a tube down the trachea from the mouth or nose of the infant to the tip of the lungs to ventilate, expand and oxygenate them). The doctor's effort at intubation failed, which further traumatized the baby. I glanced at the doctor and hesitantly asked, "Will you attempt intubation again?"
"You've got to be kidding," he replied. "It would be inhumane to attempt to intubate this poor little thing again. This infant will never survive."
"No, Doctor, I'm not kidding," I said, "and it's my job to ask."
The doctor softened for a moment. "I'm sorry, Sharon. I'm just angry. The mother doesn't want the inconvenience of a baby, so she comes to the hospital so she can pay somebody to get rid of it -- all neat and tidy. Then the whole thing gets messed up when the fetus has the audacity to survive. Then everybody takes it seriously, and they call the pediatrician, who's supposed to fix it or get rid of it." With anger in his voice, he went on, "Some lawyers will fight for the right to do whatever we want to our bodies, but watch out for what they will do when these abortions aren't so neat and tidy! A failed homicide -- and oops! Then all of a sudden everybody cares, and it's turned from a 'right' into a 'liability' that someone is blamed for!"
We looked at our pathetic little patient. He was lying in the fetal position in the wrong environment, trying to get air into underdeveloped lungs that couldn't do the job. In a calmer voice, the doctor said, "Okay, Nurse, I'm going back to the office. Keep him comfortable and let me know when it's over. I'm sorry about this. Call me if you need me. I know this is a hard one. If it helps, please know it's tough for me, too." Holding the baby's hand, I watched the doctor retreat and then glanced back at the infant before me. He was gasping for air. "Lord, help!" I prayed. Almost instinctively, I took the baby's vitals. His temperature was dangerously low. I pushed the warmer settings as high as they could go. His heart rate was about 180-200 beats per minute. I could count the beats by watching his little chest pulsate. I settled down a bit and began to focus on this tiny little person. He had no name, so I gave him one. Suddenly, I found myself speaking to the baby. "Tiny Tim, who are you? I am so sorry you weren't wanted. It's not your fault."
I placed my little finger in his hand, and he grasped it. As I watched him closely, I marveled that all the minute parts of a beautiful baby were present and functioning in spite of the onslaught. I touched his toes and discovered he was ticklish! He had a long torso and long legs. I wondered if he would have become a baseball player. Perhaps he would have been a teacher or doctor. Emotions swept over me as I thought of my friends who had been waiting and praying for years for a baby to adopt. I spoke aloud once again to the miniature baby. "They would have given you a loving and a happy home. Why would people destroy you before ever considering adoption? Ignorance is not bliss, is it, Tiny Tim?"
Hanging on meanwhile, Tim put his thumb into his mouth and sucked. I hoped that gave him comfort. I continued to talk to the baby. "I'm sorry, Tim. There are people who would risk their lives for a whale or an owl before they'd even blink about what just happened to you." Tiny Tim gasped, and his little chest heaved as if a truck were sitting on it. I took my stethoscope and listened to his tiny, pounding heart. At The moment it seemed easier to focus on physiology rather than on this baby's humanity.
He wet, and with that my mind took off again. Here was Tiny Tim with a whole set of kidneys, a bladder, and connecting tubes that functioned with a very complex system of chemistry. His plumbing was all working! I turned the overhead light up and Tim turned from it, in spite of eyelids that were fused together to protect his two precious little eyes. I thought about them. They would never see a sunset, a mother's smile or the wagging tail of a dog. I took his temperature again. It was dropping. He was gasping for air and continued to fight for life. I stroked him gently and began to sing:
"Jesus loves the little children, All the children of the world. Red and yellow, black and white, They are precious in His sight. Jesus loves the little children of the world."
A nurse walked in. "How's the mother?" I asked.
"Oh, she's fine. She's back in her room resting. The family said they don't want to see or hear about anything. They said, "Just take care of it." The nurse retreated with one last glance at the tiny patient. "For such a little person, he's sure putting up a big fight."
I looked at Tiny Tim and wondered if he knew that what he was fighting for so hard was life -- and I knew he was losing it. He was dying and his family was resting. Their words tormented me. Just take care of it! No muss and no fuss.
Then Tiny Tim moved and caught hold of my little finger. I let him hang on. I didn't want him to die without being touched and cared for. As I saw him struggle to breathe, I said, "It's okay, Tim. You can let go. You can go back to God."
His gasping started slowing down, but he still clung to my finger. I stroked the baby ever so slowly and watched him take his last breath. "Good-bye, Tiny Tim," I whispered. "You did matter to someone."
~~~~~~~~~~~~
Epilogue
A few years later, Sharon Dunsmore became the manager of a psychiatric unit. One day, Kathy, a young, severely depressed woman, came to see Sharon following an unsuccessful suicide attempt. As Sharon interviewed her, Kathy said she had gone through an abortion three years before, and she was having recurring nightmares. A baby was crying for help and kept calling her name. In her dreams, Kathy searched for the baby, but she could never find him or her. As Kathy gave the name of the hospital and the names of the doctors, a disturbing realization dawned on Sharon. Kathy was Tiny Tim's mother. Because of hospital regulations, she couldn't tell her what she knew.
Time passed. Sharon was no longer a nurse or a therapist. Kathy was no longer a psychiatric patient. They ran into each other at a restaurant, where Sharon gently unfolded the story that had been hidden for so long. Tears flowed as she gave Kathy the gift of answers. Her baby was touched and loved by a mother. He was given a name. He didn't die alone. He was sent back to a loving God.
As the visit neared an end, they held each other and wept. Sharon looked into Kathy's eyes and saw new strength and calm. There were scars, but she was beginning to heal. The nightmares were being put to rest. Sharon still lives with the haunting impact of this experience. A choice that was intended to be "no big deal" turned out to be a very big deal for everybody.
Sharon Dunsmore has Tiny Tim's story available in booklet form. For more information, write "Tiny Tim," P. O. Box 84, Smiths Creek, MI 48074-0084
*
Remember Phyllis Diller, the self-deprecating comedienne with the crazy hair and zany wardrobe? Seems like she's been around forever, and she still is around. She was on "Larry King Live" last week, looking better and younger than ever. She doesn't have those startling features to make jokes about anymore, thanks to the multiple plastic-surgeries she told us all about.
But Phyllis wasn't on the King show to be funny: She was one of several guests on the program that evening, the others being medical experts. The subject was depression. It seems that Ms. Diller, though looking anything but glum, dressed in bright red and making clever quips, was recently in the grip of a deadly depression.
It's hard to picture the lively funny lady as very ill, but Phyllis has had many health problems and was hospitalized. She had a severe reaction to a drug and was paralyzed. Finally, she wanted out.
She asked her doctors to give her a drug so she could "just float away." They refused, citing the law. "Dr. Kervorkian was in jail," she added. So, thankfully, the good "Dr. Death" did not make a call to her hospital room.
"Why did you want to die?" they asked her on the King Show. "Did aging have anything to do with it?"
"No," she said. It was being paralyzed. Helpless. She could see no way out.
So what happened? Her body healed, the paralysis left, and now she is in good health again. Larry King asked if she was glad her physicians didn't do as she had asked. Phyllis grinned and assured him: "You better believe I am!"
But the question that begs to be answered is this: What if she had lived in a European country, such as the Netherlands, that had a "Right to Die" law, or in a state like Oregon, which has legalized assisted suicide? She made a good case for her own death. She was elderly, paralyzed, in her right mind, and requested assistance in dying.
Doctors there probably would have obliged. Dr. Kervorkian, too, if he weren't under lock and key. All in the name of compassion and relieving suffering.
The only trouble is, it was the depression talking. Relieve the depression and change the circumstances, and the person with the death wish may change his mind. But "mercy killing," as it's called, is a very final solution. It allows no time for a changed mind.
People who want to die, like Phyllis Diller, see no way out. They are suffering and want to end it. But God allows suffering, pain, and dying in this world for many purposes. Some people take this time to reflect on their lives, to make amends, and to heal family rifts. Friends and family may have a meaningful experience with the suffering person, maybe for the first time.
And people who would never have done so before often seek and find God in a crisis.
If someone cannot bear the pain, doctors should relieve it. If they cannot cope with their situation, then others should help. But no one has the right to "play God" and end a life.
At the show's end, Larry King said to Phyllis, "We're glad you're still here." She was glad, too. And so are we all.
___________________________
Copyright (c) 2000 Prison Fellowship Ministries. Reprinted with permission. "BreakPoint with Chuck Colson" is a radio ministry of Prison Fellowship Ministries.
*
Sermon on sanctity of life. Deuteronomy 30:15-20
AFFIRM LIFE
===========
I. Life has a tenacity about it.
II. No life is as complex as humans.
A. In what sense are we alive?
B. We can be spiritually alive on two levels.
III. The gospel of Jesus is life-affirming.
A. Jesus loves those whom the world rejects.
B. Jesus loves YOU.
IV. Evangelicals are noted for their views on life.
A. Often takes negative slant.
B. How we can affirm the life of others.
1) Helping with the extremes of life.
2) Witness to others about our faith in Jesus.
V. How we can get the most out of life.
A. Accept God's love for us.
B. Seek to improve the quality of your life.
C. Choose life even when it is hard.
VI. We all face choices.
*
Following World War II, the Allies put Nazi Germany's surviving leaders on trial for genocide and other war crimes. The chief medical consultant for the prosecution was an American doctor named Leo Alexander.
In 1949, Alexander summed up what he had learned from his experience at the Nuremberg War Trials. He wrote in the NEW ENGLAND JOURNAL OF MEDICINE that the horrors of the Third Reich were made possible by a single idea: the belief that some lives are not worth living.
You would think that Alexander's words and the wreckage caused by Nazi barbarism would have driven that lesson home. Unfortunately, that's not the case.
The Nazis' phrase for the kind of lives Alexander wrote about was Lebensunwertes Leben, which means “lives not worth living.” They initially employed the phrase to justify killing the sick and the handicapped. They weren't concerned about individual suffering; their concern was the cost and inconvenience to society of keeping these people alive.
Once they convinced people to subject human life to a cost/benefit analysis with regards to the sick and the handicapped, it became easier to apply these standards to other groups.
Given this evil history, you'd expect that both the idea and the phrase would have been banished from German culture forever. They haven't been.
Nearly three-quarters of all Germans surveyed favor physician-assisted suicide and euthanasia. Even worse, a survey of German doctors found that 6.4 percent of hospital physicians and 10.5 percent of general practitioners had been present when a physician euthanized a patient.
To add moral insult to mortal injury, the Nazi phrase is regularly used by German advocates of physician-assisted suicide and euthanasia.
Whatever lessons Germans have learned from their history apparently did not include a high regard for the sanctity of human life. And Germans are not alone in this regard. Dutch doctors heroically opposed the Nazis two generations ago. Now, Dutch doctors murder upwards of 3,500 patients a year.
It would be foolish to think that what's happening in Europe can't happen here. Given its current trajectory, American culture is well on its way to embracing what Pope John Paul II has called “the culture of death.”
Oregon has already legalized physician-assisted suicide. At least a dozen states have considered or are considering similar measures. While none of them have joined Oregon, it may only be a matter of time. Nearly half of all doctors surveyed favor legalizing physician-assisted suicide.
So-called “death with dignity” is depicted sympathetically in the media. A generation of Americans, like a generation of Germans seventy years ago, are being taught that there is such a thing as “a life not worth living.” What they are not told is that, once a culture believes that, there's no reason for a doctor to wait for his patients to request assistance.
Making comparisons to the Nazi era can be inflammatory, but it is only fair to ask: What have we learned? Whatever else we may have learned, we have failed to understand the most important lesson: There is no such thing as “a life not worth living.” As Leo Alexander would tell you, it's the lesson that separates civilization from barbarism.
FURTHER READING AND INFORMATION
Dr. Leo Alexander, “Medical Science under Dictatorship,” NEW ENGLAND JOURNAL OF MEDICINE (July 1949). http://www.chninternational.com/leo_alexander_.htm
James A. Maccaro, “'From Small Beginnings': The Road to Genocide,” THE FREEMAN, August 1997 (posted on Liberty Haven's website). http://www.libertyhaven.com/theoreticalorphilosophicalissues/history/fromsmall.shtml
Nat Hentoff, “Are certain lives not worth living?”, JEWISH WORLD REVIEW, 27 February 2001. http://www.jewishworldreview.com/cols/hentoff022701.asp
Richard Miniter, “The Dutch Way of Death,” WALL STREET JOURNAL, 28 April 2001. http://www.opinionjournal.com/editorial/feature.html?id=95000390
Terence Monmaney, “More Doctors Found Willing to Assist Suicide Medicine,” LOS ANGELES TIMES, 6 February 1997. http://www.aegis.com/news/lt/1997/LT970201.html
BreakPoint Commentary No. 030114, “Coming Soon to a Hospital Near You: 'Futile Care' and the Culture of Death.” http://www.breakpoint.org/Breakpoint/ChannelRoot/FeaturesGroup/BreakPointCommentaries/Coming+Soon+to+a+Hospital+Near+You.htm
Also see “Abortion and the Holocaust, “ a recent “Worldview for Parents” page, for more information. http://www.breakpoint.org/Breakpoint/ChannelRoot/FeaturesGroup/WorldviewForParents/Abortion+and+the+Holocaust.htm
Wesley J. Smith, THE CULTURE OF DEATH: THE ASSAULT ON MEDICAL ETHICS IN AMERICA (Encounter, 2002).
Don Feder, “Killing Us with Kindness: How Liberal Compassion Hurts,” Heritage Lecture #574, The Heritage Foundation, 13 January 1997. http://www.heritage.org/Research/PoliticalPhilosophy/HL574.cfm
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Copyright (c) 2003 Prison Fellowship Ministries. Reprinted with permission. "BreakPoint with Chuck Colson" is a radio ministry of Prison Fellowship Ministries.
*
[Original illustration at this number was a duplicate of HolwickID #14002]
Sir Francis Crick, decoder of DNA, in a lecture entitled “The Sociological Ramifications of Biology” before University College:
“Because of the population explosion in the face of diminishing resources, we have no recourse from the following steps:
A. We cannot continue to regard all human life as sacred. The idea that every person has a soul and that his life must be saved at all costs should not be allowed. Instead, the status of birth and death should be reconsidered.
B. If, for example, a child were considered to be legally born when two days old, it could be examined to see whether it was an 'acceptable member of human society'.
C. It might also be desirable to define a person as legally dead when he is past the age of 80 or 85, and then expensive medical equipment should be forbidden to him; old people might also be required to distribute a certain proportion of their property.
D. It is not right that religious instruction should be given to young children. Instead they should be taught the modern scientific view of man's place in the universe, in the world and in society, and the nature of scientific truth.
____________
from Nature 220, Nov.1968, pp 429-430
"And in those days shall men seek death, and shall not find it; and
shall desire to die, and death shall flee from them."
\reference{Revelation 9:6}{Revelation 9:6}
Man in a coma in the hospital, 92 yrs. old, fed through a tube inserted into his stomach. Kept alive for 12 yrs. What do we tell the wife who is heavily in debt for the part the insurance company has failed to pay over the years? Is it OK to pull the plug? (The national record is 38 yrs.)
Yesterday, I told you the story of Grandpa Reitsema in The Netherlands whose doctor, without consulting the family, ordered nurses to withhold food and water and to administer overdoses of morphine. He didn't act out of malice. Instead, as he told the family, “I was just helping him out.”
This story may make you glad that you don't live in The Netherlands -- that is, until you realize that American medicine is headed in the same direction.
According to Wesley Smith of the Discovery Institute, “futile-care” theory is “one of the most dangerous topics [under discussion] in contemporary bioethics.” “Futile-care” holds that “when a physician believes the quality of a patient's life is too low to justify life-sustaining treatment, the doctor is entitled to refuse care,” calling it “inappropriate.”
This judgment prevails over the patient's and family's wishes. As Smith puts it, “It is the equivalent of a hospital putting a sign over its entrance stating, 'We reserve the right to refuse service.'“
It is important to understand the worldview that drives the “futile-care” theory. Now, no one believes that a doctor should be required to give a patient “physiologically futile” treatment -- prescribing useless therapies just because the patient may demand it.
That's not what “futile-care” is about. It is about preventing treatment that does work, that is, treatment that prolongs life. In “futile-care” theory, “bioethicists and doctors unilaterally determine” which lives are worth prolonging. As Smith notes, in “futile-care” theory, what's regarded as futile isn't the treatment -- it's the patient.
And it's not just dying patients. One “futile-care” advocate told Smith that he would deny an otherwise-healthy eighty-year-old woman a mammogram. What, the advocate argued, would be the point of treatment at her age if a problem was discovered?
This should frighten us all because, above all, doctors are not infallible. People have recovered from conditions that doctors pronounced hopeless. Doctors aren't God -- but some are seeking to usurp His prerogatives.
Even more frightening is that hospitals across the country are putting “futile-care” protocols in place. For instance, twenty-four of twenty-six California hospitals surveyed by the CAMBRIDGE QUARTERLY OF HEALTH CARE ETHICS adopted “futile-care” protocols. Bills have been introduced at the federal and state level to clarify the legality of these policies.
It's easy, from a financial perspective, to understand the appeal of “futile-care” theory. Patients “requiring intensive or extended care” are money-losers for hospitals. The rising cost of health care, especially within an aging population, increases the pressure for other hospitals to follow suit.
That's why Christians need to promote the sanctity of human life, because without a belief in the sanctity of life, all of our lives are potentially subject to a cost-benefit analysis. Only if we sustain the belief that life is sacred, created in the image of God, can we hope to prevail against the utilitarian calculus that is taking over the practice of medicine.
Our embrace of the “culture of death” has left vulnerable people at the mercy of a stranger's subjective determination about the quality of their life. As in The Netherlands, our sick and elderly have good reason to tremble when, as Smith says, they hear someone say, “The doctor knows best.”
FURTHER READING AND INFORMATION
BreakPoint Commentary No. 030113, “Who Killed Grandpa?: 'Therapeutic' Death in a Dutch Nursing Home.” http://www.breakpoint.org/Breakpoint/ChannelRoot/FeaturesGroup/BreakPointCommentaries/Who+Killed+Grandpa.htm
Wesley J. Smith, “'Doc Knows Best',” NATIONAL REVIEW ONLINE, 6 January 2003. http://www.nationalreview.com/comment/comment-smith010603.asp
Wesley J. Smith, “Killing Them Softly,” NATIONAL REVIEW ONLINE, 31 October 2000. http://www.nationalreview.com/comment/comment103100c.shtml
Wesley J. Smith, THE CULTURE OF DEATH: THE ASSAULT ON MEDICAL ETHICS IN AMERICA (Encounter, 2002). http://www.encounterbooks.com/inprogress/culturedeath.html
Visit the International Task Force on Euthanasia and Assisted Suicide for more information. http://www.internationaltaskforce.org/
“Hospitals limit care to the dying,” WATERLOO-CEDAR FALLS COURIER, 2 January 2003. http://www.wcfcourier.com/topnews/030102hospitals.html
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Copyright (c) 2003 Prison Fellowship Ministries. Reprinted with permission. "BreakPoint with Chuck Colson" is a radio ministry of Prison Fellowship Ministries.
*
[Original illustration at this number was a duplicate of HolwickID #18581]
In 1994, voters in the state of Oregon narrowly approved the first law in the United States allowing physician-assisted suicide. Three years later, an attempt to repeal the law was defeated at the ballot box. It is clear that the majority of voters in the Beaver State believe a person has a right to decide when his or her life should end.
In 1999, the Oregon legislature voted to expand the coverage of the state-sponsored health plan to include physician-assisted suicide. In the state of Oregon not only can a person end his or her life with a doctor's help, but he or she also can have the government foot the bill for the "procedure."
On Wednesday, April 17, U.S. District Judge Robert E. Jones rejected an attempt by U.S. Attorney General John Ashcroft to apply the Controlled Substance Act to Oregon doctors who use the physician-assisted suicide law to prescribe lethal doses of medication to those seeking to end their lives prematurely.
Ashcroft's decision held that assisted suicide is not a legitimate medical procedure, threatening to revoke the licenses of physicians who prescribed deadly doses of drugs to patients. Judge Jones disagreed with the attorney general and his ruling allows assisted suicide in Oregon to continue unfettered.
The majority is elated, asserting it is a victory for individual rights as well as the democratic process. The voters of Oregon have expressed their will not once but twice: If a person wants to choose the time, place and circumstance of his or her death, what business is it of the government? We are told that society is not harmed by such a decision.
One question: What if the voters in Oregon are wrong and their populist view concerning physician-assisted suicide is not a victory for an individual's right to die, but rather the next progression down the slippery slope toward forced euthanasia?
We must not too quickly forget the reality that occurred in Nazi Germany. In "Modern Fascism: The Liquidating of the Judeo-Christian Worldview," Gene Edward Vieth Jr. reminds us, "The first official legalized 'mercy killing' [in Nazi Germany] was the result of an emotional case brought before the Fuhrer himself. A baby named Knauer was born blind, missing a leg and part of a hand, and evidently mentally retarded. The father begged permission for the child to be put out of his misery. Hitler himself investigated and granted permission. More petitions followed."
Writing in "The Nazi Doctors," Robert Jay Lifton points out, "Of the five identifiable steps by which the Nazis carried out the principle of 'life unworthy of life,' coercive sterilization was the first. There followed the killing of 'impaired' children in hospitals; and then the killing of 'impaired adults,' in centers especially equipped with carbon monoxide gas. This project was extended (in the same killing centers) to 'impaired' inmates of concentration and extermination camps and, finally to mass killings, mostly of Jews, in the extermination camps themselves."
Those who favor physician-assisted suicide loudly declare, "No way infanticide and forced euthanasia will ever occur in the United States. We are too enlightened." They accuse people like me of knee-jerk reactions and of trying to impose our puritanical morality on the enlightened majority. Well, to that charge I have two words in reply: Peter Singer. Singer is professor of bioethics at Princeton University. He espouses both infanticide and forced euthanasia. Singer, who is a radical utilitarian, believes that a life incapable of "full life" should not be prolonged. He holds that the good of society must be considered in determining whether a life is worth preserving.
Peter Singer is only one man. His views seem too radical for mainstream America. However, what if one man -- as wrong as his views might be -- over time is able influence a majority? What then?
In 1930, Germany embraced the Nazi Party. Shortly thereafter the leader of the party, Adolf Hitler, was appointed chancellor. On March 23, 1933, Hitler pressed the German cabinet to pass the Enabling Act that would result in him being named legal dictator -- and the demise of democracy in Germany.
The Enabling Act involved altering the German Constitution, requiring passage by a two-thirds majority of the Cabinet. Hitler needed 31 non-Nazis to vote in favor of the act in order for him to become dictator.
One lone voice spoke in opposition to Hitler's grab for power. Otto Wells, leader of the Social Democrats stood and took issue with the head of the Nazi Party. In the end, Wells' voice was ignored and the Enabling Act passed. Hitler became the dictator because that was the desire of the majority. One man influenced a majority. The rest, as they say, is history. And history has proved the majority was wrong.
A majority of voters in Oregon approve of physician-assisted suicide. Thankfully, this view is still a minority in America. If this ever changes, and the majority embraces the view that life is disposable, we will all suffer.
______________________
(previous illustration with this number was a duplicate of HolwickID #22215)
On a KLM flight to Amsterdam two weeks ago, I had a conversation with a member of the crew that chilled me to the bone. It illustrates what happens when the church fails to teach the hard truths of our faith.
KLM is the Dutch airline. The flight crew was gracious, but one middle-aged woman called Marget was exceptionally friendly. As she cleared away the breakfast dishes, Marget asked what we were planning to do in Amsterdam. I told her I was speaking at the Billy Graham Conference on Evangelism. I also mentioned that I work in the prisons.
In response, Marget told me she was a practicing Catholic and that she sang in a choir that performed in prisons.
Since I was talking to a Christian, I thought I'd find out what Marget thought about euthanasia, which, of course, is legal in Holland. I assumed she would find it abhorrent, but to my astonishment, she gave an impassioned defense of it. She said she had seen her grandmother waste away in agony. The family wanted to help her die, but before they could arrange it, she died naturally.
I explained to Marget that suffering could be managed without taking life. She replied that she had seen everything tried with her grandmother. I asked if other Dutch Christians shared her views. Yes, she replied -- everybody thinks euthanasia is wonderfully humane because it enables us to help eliminate suffering.
I challenged her with every argument I could think of. I told her that God puts our souls in our bodies when life begins and that humans cannot make the decision to take it. Marget, always smiling warmly, stood her ground. She insisted that euthanasia is a kind thing -- that it's consistent with the views of good people.
Well, I didn't change her; needless to say she did not change me.
This woman was sincere about her faith and she really believed she was doing the right, kind, loving, and gentle thing -- yes, in her eyes, a Christian thing.
She brought to mind C. S. Lewis's description of how the greatest evil is done not in sordid dens of crime, or even in concentration camps. "In those we see its final result," Lewis notes. "But it is conceived and ordered ... in clean ... warmed, and well-lighted offices, by quiet men with white collars ... who do not need to raise their voices."
I confess, I got off that plane shaken. I realized that so often in a culture war, we're not up against evil people who enjoy killing. Instead, we're up against good, decent people who genuinely think it's humane and right to kill.
Good Christians, like Marget.
Marget's attitude signals a profound failure of the church. Everywhere we look, our culture is promoting euthanasia, abortion, and infanticide as loving, humane solutions. We even hear abortion of poor children talked about the same way.
The challenge of the church is to confront this dangerous philosophy head on. Voluntary euthanasia leads directly to involuntary euthanasia, as is happening in Marget's Holland.
You and I must teach the good people around us that euthanasia doesn't raise the curtain on a more "humane" society. Instead, it's the final curtain call on a culture of death.
___________________
Copyright (c) 2000 Prison Fellowship Ministries. Reprinted with permission. "BreakPoint with Chuck Colson" is a radio ministry of Prison Fellowship Ministries.
*
It sounds like the baby shower from hell. As cake and punch are passed around, a doctor runs medical tests on a month-old baby. If he passes the tests, the guests welcome the child to the human community. But if the baby fails -- if he has, say, Down's syndrome, or cerebral palsy -- the parents bid him a sad farewell.
And then, the doctor snuffs out his life.
Believe it or not, a Princeton professor thinks parties like these would be a good idea. This is a tragic illustration that the killing of a month-old child -- once absolutely unthinkable -- has become a debatable moral question.
In an article entitled "Killing Babies Isn't Always Wrong," philosopher Peter Singer writes: "Perhaps, like the ancient Greeks, we should have a ceremony a month after birth, at which the infant is admitted to the community. Before that time," he says, "infants would not be recognized as having the same right to life as older people."
This means that if the child is considered "defective" in some way, the parents would presumably have a different kind of ceremony -- one that ends with child being admitted, not to the human community, but to a grave.
This is morally acceptable, Singer says, because newborns, while indisputably human, are not really persons. They don't become persons, and acquire a right to life, until weeks or even months after birth because they lack "self-awareness."
Extreme beliefs, yes, but Singer is hardly alone in espousing them. As far back as 1972, University of Colorado philosopher Michael Tooley was saying that fetuses and infants are non-persons who "do not have a right to life."
American University philosopher Jeffrey Reiman agrees. He maintains that infants do not "possess in their own right a property that makes it wrong to kill them." I could go on and on. But suffice it to say that people who wish to destroy handicapped or just plain unwanted newborns have influential supporters. And they're getting more and more aggressive.
Well, we can't say we weren't warned. In the 1960s, as the abortion movement gained momentum, critics warned that the logic of abortion would lead directly from the womb to the cradle: Babies already born would become the next targets.
These critics have been proven right. Three decades after Roe V. Wade, influential voices are clamoring for out-and-out infanticide.
The reasoning behind it -- that newborns are somehow less than human -- is already seeping into society. Witness the rash of "dumpster babies" -- newborns thrown out by their mothers.
If this nation ever condones infanticide, we will be destroying the very principle that is at the heart of Judeo-Christian concepts of human rights and equality, namely, that it's always wrong to deliberately kill innocent human beings.
Florida Congressman Charles Canady is among those trying to prevent this dangerous redefinition. He has introduced a bill called the "Born Alive Infants Protection Act." Now, I know the abortion issue has been around a long time, and people get weary of it. But I urge you to learn more about this bill, and you can do so by visiting our BreakPoint webpage (www.breakpoint.org).
A bill like this is a vital and important protection against those hideous "baby showers" that Peter Singer proposes -- celebrations that end only in death.
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Copyright (c) 2000 Prison Fellowship Ministries. Reprinted with permission. "BreakPoint with Chuck Colson" is a radio ministry of Prison Fellowship Ministries.
When Joni Eareckson, an attractive teenager, stepped into a boat on Chesapeake Bay, she had her whole life ahead of her. She dreamed the dreams of most healthy young women -- marriage, home, children, and career. One mistake, however, one unplanned dive into shallow water, broke her neck. Since that moment, Joni's body has been helpless. She knows she will never leave her wheelchair.
Those who embrace a utilitarian worldview might consider Joni Eareckson worthless, a drain on society. "What can a person accomplish for the good of society when she can't walk or feed herself or even control her bodily functions?" they might ask.
I reflected on Joni's life recently when I attended a White House meeting with President Bush who spoke so eloquently about the need for a total ban on human cloning. As he spoke in the terms of a moral theologian about the dignity and sanctity of life, in the first row, just below the podium, directly in line with the president, sat Joni in her wheelchair. She is a powerful counterpoint in the cloning debate to Christopher Reeve, the wheelchair-bound defender of destructive embryonic stem cell research he believes will allow him to walk again.
Joni has known much suffering in her lifetime, and she might have despaired. But she has never exhibited self-pity. She has joyfully pursued God's purpose for her life in ministry and advocacy on behalf of the handicapped and in these vitally important debates on bioethics.
Several times during his talk, I saw President Bush look directly at Joni. At the end of his speech, the president surprised everyone. Stepping from the podium, he put his arms around Joni and embraced her and kissed her. It was a moving moment. Surely, I thought, this was the moment and the issue for which Joni had been born. There was a purpose for all her suffering.
With us in the White House that day also was Nigel Cameron, Dean of the Wilberforce Forum and Director of our Council for Biotechnology Policy. I met Nigel more than fifteen years ago when he was a young scholar in Edinburgh. At the time Nigel told me that abortion was only Bioethics 101 and that we would soon face much greater challenges in euthanasia, cloning, and germline intervention. I'm not sure I believed him, and probably many others didn't either. It must have, from time to time, been discouraging for him as he developed the bioethics arguments, and no one else really seemed to care. But recent developments have proved him absolutely right. He was the one alerting the Christian view, and Nigel Cameron is now one of the world's leading experts in bioethics, the most critical moral issue of the twenty-first century. He helped organize the coalition assembled in the White House that day.
As I think about Joni and Nigel and the roles they play in the bioethics debate, I'm reminded of the verse from the Old Testament book of Esther. The people need saving, and Esther was told that perhaps she was the queen "for such a time as this."
Sometimes people wonder why certain things happen to them. Why do we experience this trial or that setback? When I look at Joni and Nigel, I think back on my own days in prison -- it's obvious God uses suffering often to do His greatest work. He prepares us for just "such a time as this."
For more information:
"Bioethics and the Christian: An Interview with Joni Eareckson Tada"
You can read the text of President Bush's speech on the Wilberforce Forum website
Learn more about Joni Eareckson Tada's group, Joni and Friends, at its website .
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Copyright © 2002 Prison Fellowship Ministries. Reprinted with permission. 'BreakPoint with Chuck Colson' is a radio ministry of Prison Fellowship Ministries.
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Princeton University professor Peter Singer, dubbed the "godfather" of animal rights, says Christianity is a "problem" for the animal rights movement.
Singer, author of the book "Animal Liberation" and a bioethics professor at Princeton University's Center for Human Values, criticized American Christianity for its "fundamentalist" strain that takes the Bible too "literally" and promotes "speciesism" in a June 29 address to the national Animal Rights 2002 conference in McLean, Va., CNSNews.com reported.
Speciesism, as defined by Singer, is the belief that being a member of a certain species "makes you superior to any other being that is not a member of that species."
Singer also expanded on his controversial position that a "severely disabled" infant may be killed up to 28 days after its birth if the parents deem the baby's life is not worth living.
"I think that mainstream Christianity has been a problem for the animal movement," Singer told about 100 people attending a workshop on "When Is Killing OK? (Attacking animals? Unwanted dogs & cats? Unwanted or deformed fetuses?)"
He singled out the "more conservative mainstream fundamentalist views" that "want to make a huge gulf between humans and animals" as being the most harmful to the concept of animal liberation.
Singer rejected what he termed "the standard view that most people hold" -- that "just being human makes life special." He told one questioner from the audience, "I hope that you don't think that just being a biological member of the species homo sapiens means that you do have a soul and being a member of some other species means they don't. I think that would trouble me.
"I am an atheist, I know that is an ugly word in America," he added.
Singer pointed out that the Judeo-Christian ethic teaches not only that humans have souls and animals don't, but that humans are made in the image of God and that God gave mankind dominion over the animals. "All three taken together do have a very negative influence on the way in which we think about animals," he said.
His mission, Singer said, is to challenge "this superiority of human beings," and he conceded that his ideas go very much against the grain of a country that mostly still believes in human superiority.
Singer also reiterated one of his most controversial positions regarding the right to kill a newborn infant within 28 days of birth if the infant is deemed "severely disabled."
"If you have a being that is not sentient, that is not even aware, then the killing of that being is not something that is wrong in and of itself," he stated.
"I think that a chimpanzee certainly has greater self-awareness than a newborn baby," he told CNSNews.com.
He explained that "there are some circumstances, for example, where the newborn baby is severely disabled and where the parents think that it's better that that child should not live, when killing the newborn baby is not at all wrong ... not like killing the chimpanzee would be. Maybe it's not wrong at all."
He said his original view, published in his book "Practical Ethics," that the parents should have 28 days to determine whether the infant should live has been modified somewhat since the book's release.
"So in that book, we suggested that 28 days is not a bad period of time to use because, on the one hand, it gives you time to examine the infant to [see] what the nature of the disability is; gives time for the couple to recover from the shock of the birth to get well-advised and informed from all sorts of groups, medical opinion and disability and to reach a decision.
"And also I think that it is clearly before the point at which the infant has those sorts of forward-looking preferences, that kind of self-awareness, that I talked about. But I now think, after a lot more discussion, that you can't really propose any particular cut-off date."
He now advocates that the life or death decision regarding the infant should be made "as soon as possible after birth" because the 28 day cut-off, based on an ancient Greek practice, is "too arbitrary."
He called his views on killing "non-speciest" and "logical" because they don't "depend on simply being a member of the species homo sapiens."
Singer was asked several questions about whether his concept of animal rights included the protection of insects, rodents or shellfish. "I think insects are, you are right, the toughest conflicts we generally face. I wouldn't kill a spider if I can avoid killing a spider and I don't think I need to," he said.
What if termites were threatening his home? "With termites that are actually eating out the foundation of my home, and this happens, this is a more serious problem and I think at that point, I would feel that I need to dwell somewhere and if I can't drive them away in some way, I guess I would end up killing them," he conceded.
When asked by CNSNews.com why humans should not be able to eat animals when animals eat other animals, Singer acknowledged that humans have to be held to a different standard.
"Animals generally are not making moral choices. Animals are not the same as humans. They can't reflect on what they are doing and think about the alternatives. Humans can. So there is no reason for taking what they do as a sort of moral lesson for us to take. We're the ones who have to have the responsibility for making those choices," he said.
One woman at the workshop, who identified herself only as Angie, asked Singer if killing humans is acceptable to defend animals. "My name is Angie and I am not going to kill anybody, but I have a question about self-preservation, because I am thinking about doing a goose intervention where people are going to be coming to my neighborhood to kill geese. I am wondering, would it be my right to kill somebody that is harming, that is killing, 11,000 geese in New Jersey?"
Singer replied, "For starters, I think it would be a very bad thing to do to the movement." He later explained that he does not support violence to further the cause of animal rights, but he does support civil disobedience, such as "entering property, trespassing in order to obtain evidence."
Singer also defended his previous writings that humans and nonhumans can have "mutually satisfying" sexual relationships as long as they are consensual. When asked by CNSNews.com how an animal can consent to sexual contact with a human, he replied, "Your dog can show you when he or she wants to go for a walk, and equally for nonviolent sexual contact, your dog or whatever else it is can show you whether he or she wants to engage in a certain kind of contact."
Animal rights activists attending the conference had nothing but praise for Singer and his influence on the movement.
Singer, who was introduced as the "godfather" of animal rights, received three standing ovations during his keynote address, attended by about 400 people. Conference participant Jennie Sunner called Singer "fundamental to the movement's inception and its movement forward."
"I am so relieved he exists.... He's so well-reasoned and well-thought-out that it is hard for someone not to agree," she added.
"I think he's got a really important message and a really inspiring message," stated David Berg of the Utah Animal Rights Coalition.
Those participating in the conference had a wide variety of animal-related issues on their agenda, from anti-fur campaigns to promoting veganism to lobbying against "factory farming."
T-shirts and bumper stickers seen at the conference included the following slogans: "Stop Hunting"; "Milk is Murder"; "Animal Liberation: Wire Cutters are a terrible thing to Waste" (with an image of a cut farm fence); "Beef, it's what is rotting in your colon"; and a T-shirt featuring a cow with the slogan, "I died for your sins."
Barry Clausen, a critic of the Animal Rights movement and author of the book "Burning Rage," has studied the animal rights movement for 12 years and believes it is having an impact.
Clausen, whose book details the illegal activities of some members of the animal rights and environmental movements, believes the biggest threat animal rights advocates pose is their ability to limit animal medical research.
"If we can't have animal research, we can't have solutions to medical problems. You just can't stop everything to save a chimpanzee," he told CNSNews.com.
Clausen said some animal rights activists have been involved in acts of what he calls domestic terrorism. "Over the past 12 years, we have had over 3,000 acts of terrorism by environmental and animal rights extremists," he said.
Clausen does not pull any punches when it comes to his opinion of the animal rights activists. "I have not come across one of these people who I did not consider to be mentally ill," Clausen said.
But conference participant Sunner defended the animal activists.
"Being normal by nature means you will never do anything extraordinary, so everything revolutionary that is good has been preceded by that kind of ridicule and trivialization," she said.
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Morano is a staff writer with www.CNSNews.com.
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For years TUESDAYS WITH MORRIE dominated the NEW YORK TIMES bestseller list. It became nothing less than a cult classic. I decided I had better read it because everybody was talking about it. And so I spent two of the most despairing nights of my life wading through the book. When I finished it, I felt uncomfortable for days.
TUESDAYS WITH MORRIE records the slow death from Lou Gehrig's disease of Morrie, a professor at Brandeis University. One of his students learned of his illness, got in touch with him, and arranged to talk with him weekly. Morrie had no religious beliefs, and the whole chronicle of death is a meaningless exercise -- just pain and suffering.
Now I know many people loved the book because they found the professor a heroic and sympathetic character. But it makes me wonder why we can enjoy reading about someone going through a slow agony. I felt the book was exploitive and the cheapest kind of sensationalism. To my mind, TUESDAYS WITH MORRIE is emblematic of existential despair. Riding to the rescue, like the cavalry of old, comes my friend Richard John Neuhaus who has an uncanny knack of speaking to the needs of modern American life.
On January 10, 1993, Neuhaus collapsed in his apartment. While he had had stomach pains for over a year, the cancerous tumor was never diagnosed. That day it burst, and Neuhaus found himself camped at death's door for a year.
He came within a whisker of dying, and everything that could go wrong did. But having recovered, miraculously, he's now written about the experience.
Much of the book is Neuhaus's fascinating philosophical ruminations about death. But in the end he comes to the realization that he really doesn't have to worry about those things. Whether the personality or consciousness continues, or what form we are in, or what part of us survives are all interesting philosophical questions. But in the final analysis, lying on the bed, he came to realize that what matters is Jesus. "In the destiny of Christ is my destiny," he writes. "When I die, in His body, body and soul are reunited. The maggots should enjoy me while they can -- they will not have the last word." We don't just wither away through terrible dehumanizing experiences like Morrie did. Life is not a cruel, mean hoax. Life is a gift from a loving and gracious God Who superintends our birth, life, and death. As the psalmist says, "Precious in the sight of the LORD is the death of His saints" (Psalm 116:15). TUESDAYS WITH MORRIE helped me understand why some people tragically want to take a pill and end it all, or why some become advocates of assisted suicide. (Who knows? Maybe that was the book's hidden agenda.) By contrast, reading AS I LAY DYING made me feel exhilarated because, as a Christian, I have a great hope, expressed not in profound philosophical terms, but in simple intimacy with Jesus. It's the kind of book Christians can give to their secular friends. After all, everybody thinks about dying.
If you've read TUESDAYS WITH MORRIE, I hope you'll now read AS I LAY DYING. You'll see two worldviews in stark contrast, and you'll see the hope of the Gospel shining bright in the dark passage of life each one of us will one day walk.
[see also HolwickID #25607]
FURTHER READING & INFORMATION
In "As I Lay Dying: Meditations upon Returning (Basic Books, 2002), author Richard John Neuhaus "draws on philosophy, psychology, science, poetry, literature, and theology - all reflected through his own personal experience - in speaking to the questions he asked himself on his journey back to life"
Richard John Neuhaus is the editor-in-chief of First Things, the Journal of Religion and Public Life. http://www.firstthings.com/index.html
Mitch Albom, Tuesdays with Morrie: An Old Man, a Young Man, and Life's Greatest Lesson (Doubleday, 1997).
Ravi Zacharias, Can Man Live without God? (Word Books, 1994).
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Copyright © 2002 Prison Fellowship Ministries. Reprinted with permission. "BreakPoint with Chuck Colson" is a radio ministry of Prison Fellowship Ministries.
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Kdo je doktor smrt
Nìkteøí øíkají, že Jack Kevorkian je andìl milosrdenství. Jiní ho považují za masového vraha
Kevorkian pomohlodejít ze života 20 lidem a od té doby více než stovce dalších. Nechal je buï vdechnout oxid uhelnatý, nebo jim píchl smrtící injekci. O svého posledního klienta, dvaapadesátiletého Thomase Youka, se "postaral" loni 17. záøí. Videozáznam jeho smrti pak poskytl televizní stanici CBS.
Posedlost
Jack Kevorkian se narodil 26. kvìtna 1928 v Pontiaku ve státì Michigan. Jeho rodièe byli arménští uprchlíci a v dìtství mu vyprávìli o zvìrstvech, která za 1. svìtové války na Arménech páchali Turci.
Medicínu vystudoval na Lékaøské fakultì Michiganské univerzity a v polovinì padesátých let zahájil v jedné detroitské nemocnici pokusy, za které si vysloužil pøezdívku doktor Smrt.Posedlost smrtí se projevuje i na obrazech, které maluje. Jejich hlavním námìtem je od šedesátých let násilí a smrt. Na obraze s názvem Genocida neváhal potøísnit rám svou vlastní krví.
Smrt na požádání
Kevorkian tvrdí, že mu kariéru znièil pouze jeho zájem o smrt.
Po tom coodešel do dùchodu,penze mu umožnila naplno se vìnovat "specializaci", kterou sám vytvoøil – ordinování smrti. V roce 1987 dal do místních novin inzerát následujícího znìní: "Lékaøské konzultace pro nevyléèitelnì nemocné, kteøí si pøejí dùstojnou smrt." Na vizitky si nechal vytisknout: "Dr. Jack Kevorkian. Bioetika a eutanazie. Úmrtní poradenství. Pouze po osobní konzultaci."
Smutná bilance
Pitva devìtašedesáti Kevorkianových klientù ukázala, že mnozí nebyli nevyléèitelnì nemocní, a nìkteøí dokonce ani nemìli žádný patologický nález. Hlavní soudní lékaø oaklandského okresu L. J. Dragovic prohlásil, že v ohrožení života bylo pouze šestnáct z nich, zatímco osmaètyøicet dalších trpìlo chorobami, které lze léèit. U zbývajících pìti se žádné pøíznaky nemoci nenašly.
Prvního záøí loòského (1999) roku vstoupil v Michiganu v platnost nový zákon, který asistovanou sebevraždu zakazuje. O šestnáct dní pozdìji aplikoval Kevorkian smrtící dávku chloridu draselného Thomasi Youkovi, který trpìl nervovou chorobou v závìreèném stadiu. Bìhem svého vystoupení v televizi prohlásil: "Musejí mì obvinit, protože jinak by to znamenalo, že mùj skutek za zloèin nepovažují. Další dùkazy pøece snad už nepotøebují, ne?"
Michiganský státní návladní jeho pøání vyhovìl a za úèast na Youkovì smrti ho postavil pøed soud. Letos v bøeznu ho porota shledala vinným z vraždy druhého stupnì a 13. dubna byl odsouzen k deseti až pìtadvaceti letùm vìzení.
Ve své závìreèné øeèi soudkynì Jessica Cooperová prohlásila, že proces nemìl rozhodnout o správnosti èi nesprávnosti eutanazie. "Byl jste souzen pouze vy, pane Kevorkiane, vaše nezákonné jednání, vaše arogance a neúcta ke spoleènosti. Mìl jste tu drzost objevit se v televizním vysílání, abyste svìtu ukázal, co jste provedl. Vyzval jste zákon, aby vás zastavil. Teï jsme vás tedy zastavili."
In a 1995 encyclical entitled "The Gospel of Life," Pope John Paul II coined the phrase "the culture of death." By this, he was referring to the combination of laws and political and cultural institutions that systematically undermine the value of human life in Western nations.
One of the most important forces working in the culture of death is the field known as "bioethics" -- that is, the ethical standards being embraced to deal with medical and biological questions.
In his new book, appropriately entitled THE CULTURE OF DEATH, J. Wesley Smith chronicles what he calls "the assault on medical ethics in America." Smith analyzes the practices and philosophies that have taken the medical profession away from the moral certainty provided by the maxim of the Hippocratic Oath, "First, do no harm."
As Smith tells readers, the bioethics establishment "[rejects] what until now has been the core value of Western civilization: that all human beings possess equal moral worth."
As a result of this rejection, bioethicists increasingly embrace the idea that there are lives that are not worth living -- that the right to life is contingent on an arbitrary idea known as "quality of life."
This idea leads to the conclusion that some patients, especially the elderly, have an affirmative duty to die, so as not to waste scarce resources. Unbelievable.
Well, this is more than theory. As Smith points out, the fruits of this worldview are visible in the increased talk about "patient autonomy," a term used to justify abandoning patients to hasten their deaths. We see it in the increasingly routine withdrawal of feeding tubes from disabled or terminal patients.
If talk of "lives not worth living" reminds you of the Third Reich, you're not alone. Columnist Nat Hentoff makes the same connection in a recent column. He reminds readers that it was the Nazis who coined the expression "lives not worth living," to describe the incurably ill and disabled. They called them "useless eaters" -- a phrase that anticipates the removal of feeding tubes.
Unfortunately, Smith doesn't make the connection between abortion and the "assault on medical ethics" he describes. It's unfortunate because it was legalized abortion, more than anything else, that taught Americans that human beings -- especially at the beginning and end of life -- don't all possess equal moral worth. It was abortion that introduced Americans to the concept of disposable human life.
Still Smith's book provides an invaluable service to the cause of life. It's both a warning as to how much our culture has embraced the culture of death, and it's a resource for helping us to spread the word about the deadly consequences of this fatal embrace.
Even if our neighbors roll their eyes at the mention of the words "pro life," they've still got a stake in this debate. As Smith concludes:
"We all age. We fall ill. We grow weak. We become disabled. A day comes when our need to receive from our fellows adds to far more than our ability to give in return. When we reach that stage of life ... will we still be deemed persons entitled to equal protection under the law?"
And all that stands between us and that bleak prospect is the Gospel of Life.
For further reference:
Hentoff, Nat. "Licensed to Kill; A New Awareness of our Culture of Death." Washington Times, 26 February 2001.
Smith, J. Wesley. The Culture of Death: The Assault on Medical Ethics in America. San Francisco: Encounter Books, 2001.
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Copyright (c) 2001 Prison Fellowship Ministries. Reprinted with permission. "BreakPoint with Chuck Colson" is a radio ministry of Prison Fellowship Ministries.
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Not long ago, I listened to perhaps the most powerful and eloquent speech I have ever heard. It was delivered by Joni Eareckson Tada at a Prison Fellowship banquet. Many of you, of course, know Joni's story: As a teenager, she dove into shallow water and broke her neck. For thirty-five years, she has lived in a wheelchair, a quadriplegic.
It was this fact that gave her speech such power. You see, the subject of her speech was embryonic stem cell research, which has been dangled out as a “miracle cure” for dozens of different medical conditions -- including spinal cord injuries. Indeed, one the most aggressive proponents of this research is another quadriplegic: actor Christopher Reeve. Both Reeve and Joni know what happens during embryonic stem cell research: The embryo -- a tiny human being -- is killed as stem cells are plundered for use by the already born.
Reeve is willing to overlook this inconvenient fact; Joni is not. Unlike Reeve, she understands where such research will lead.
Consider what Joni said: “The weak, the frail, quadriplegics, the infirm, the handicapped, the elderly have never fared well in cultures which view life as a commodity.” Look what happened just more than fifty years ago in Germany, she said, when doctors first cast a cold eye on people whose lives they considered not worth living. “The first to be carted off down the long, dark, midnight hallways of institutions were the defective, or the handicapped, or the mentally disabled.” Specifically, they were “disabled people,” Joni said, “who had no visitors, no friends, no one to speak up for them.”
“And now we have the philosophers of this age,” she said, “people like Peter Singer insisting that folks like those with mental handicaps have no rights.”
And she added: Our dream of solving all medical problems is turning into a nightmare. “Our society doesn't seem to have a place for those who suffer. We want to avoid [suffering,] ignore it, eradicate it, medicate it. We have such contempt for suffering, and it's only a short philosophical hop, skip, and jump to where you begin to have contempt for suffering people. People who strain Medicare, people who drain the grandkids' college funds, people who contribute nothing more than bills to society.”
But, as Joni pointed out, it is not just the disabled who are at risk. “The lives of all of us are jeopardized when life can be bought and sold, copied and replicated, altered and aborted and euthanized,” she warned. We are all vulnerable “in a society that thinks nothing of creating a class of human beings for the purpose of lethal experimentation and exploitation.” Those are powerful words, given with such conviction.
Of course, we all want cures for disease and disability, as Joni said, but not at the price of human dignity. She knows, as Reeve does not, what a bad bargain it is. The promise of a cure is seductive, but it becomes a death warrant.
Unlike Christopher Reeve, Joni knows that there are worse things in life than being handicapped. There is the destruction of human dignity through cloning. And there is the creation of a cultural climate where first the weak, the small, the sick, and the suffering, and then all of us are carted down the “long, dark, midnight hallways.”
FURTHER READING AND INFORMATION
“Bioethics and the Christian” -- In this “BreakPoint This Week” special with Wilberforce Forum Dean Nigel Cameron, Joni Eareckson Tada shares her thoughts on the “biotech century” and how Christians should respond. http://www.breakpoint.org/Breakpoint/ChannelRoot/FeaturesGroup/Bioethics+and+the+Christian.htm A CD of this conversation is also available.
The “BreakPoint Christian Response to Cloning Kit” includes useful resources for Christians (laity and church leaders): to understand why they should stand up for human dignity and the sanctity of human life (an audio cassette of Joni Eareckson Tada's speech delivered at the Prison Fellowship banquet); to speak to their fellow believers about the issue; to speak to unbelievers about the dangers of human cloning; and to take the first step toward opposing all human cloning.
Learn about Joni Eareckson Tada's ministry, Joni and Friends. http://www.joniandfriends.org
Senator Sam Brownback, “A True, Complete Ban,” NATIONAL REVIEW ONLINE, 26 February 2003. http://www.nationalreview.com/comment/comment-brownback022603.asp
Roberto Rivera, “Attack of the (Real Life) Clones,” BOUNDLESS, 29 August 2002. http://www.boundless.org/2001/features/a0000620.html
BreakPoint Commentary No. 030226, “'An Obvious Moral Absurdity': A Secular Case against Cloning.” http://www.breakpoint.org/Breakpoint/ChannelRoot/FeaturesGroup/BreakPointCommentaries/An+Obvious+Moral+Absurdity.htm
BreakPoint Commentary No. 030103, “Creating and Killing: Bioethics and the Future of Humanity.” http://www.breakpoint.org/Breakpoint/ChannelRoot/FeaturesGroup/BreakPointCommentaries/Creating+and+Killing.htm
David Stevens, M.D., “Stem Cells -- Potential and Problems: Adult vs. Embryonic Stem Cells,” Council for Biotechnology Policy, 27 September 2002. http://www.biotechpolicy.com/BiotechPolicy/ChannelRoot/Features/Articles/Stem+Cells+Potential+and+Problems.htm
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Copyright (c) 2003 Prison Fellowship Ministries. Reprinted with permission. "BreakPoint with Chuck Colson" is a radio ministry of Prison Fellowship Ministries.
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[Original illustration at this number was added to HolwickID #17203]
In 1990, a seizure left Terri Schiavo of St. Petersburg, Florida, with severe permanent brain damage -- dependent on a feeding tube to sustain life. But today Terri's life is threatened by something even more dangerous than a seizure: namely, today's culture of death and its false notion of compassion.
Two years after her trauma, Terri's husband, Michael Schiavo, was awarded $2 million by a jury in a malpractice suit against her doctor. The money would go to keep her alive. At the trial, Mr. Schiavo testified that he believed his marriage vows -- "till death do us part."
Well, Michael's timeframe seems to have shrunk a bit. Four months after receiving the damage settlement, Mr. Schiavo began maneuvering to find a way to end his wife's life. He requested a "Do not resuscitate" order and then he tried to prevent the nursing home from giving Terri antibiotics to treat a potentially lethal infection. (And yes, if she died Mr. Schiavo would get what's left of the $2 million.)
In 1997, Schiavo filed a petition asking for Terri's artificial feeding to be discontinued. He told the court that while she was alive Terri gave him an "oral living will" that provided that she not be kept alive by artificial means.
But as WORLD Magazine reported recently, she's not being kept alive by what most people would call artificial means. Moreover, neurologists who've examined Terri say she's not in a "persistent vegetative state." Dr. Richard Neubauer, an expert in cases like this, said in an affidavit that Terri Schiavo is both "viable" and "semi-responsive" to her environment.
And that's why Terri's parents opposed Michael's petition. In addition, they presented evidence that Mr. Schiavo may have been less than forthcoming in his testimony.
Nevertheless, despite the evidence, a trial court granted his petition -- a judgment that was recently affirmed by the court of appeals. So barring a change of heart by the judge, any day now Terri Schiavo's feeding tube will be removed.
The next time you hear somebody scoff at terms like "culture of death" and "slippery slope," I hope you'll remind them of Terri's case. From the beginning, "right to die" advocates have dismissed concerns about where this so-called "right" would lead. They claim that legal requirements -- like a written will -- would prevent abuse. No one would die simply because they were a burden to their family.
Well, those assurances have proven hollow. Despite doubts about her actual condition, and on the basis of the most dubious claims, Terri Schiavo is set to die. And this is what is the "culture of death" is really all about. Disavowal of the "sanctity of life" has taken death from being merely the last resort to the option-of-choice for dealing with society's weak and helpless.
This was inevitable because on a slippery slope the trajectory is always downward. That's why we call it slippery. The only way to avoid that downward trajectory is to stay off the slope in the first place -- by rejecting the idea of a "right to die."
George Orwell said that we're seldom so cruel as when we seek to be kind. For Terri Schiavo that's apparently true. And her case reminds us that few things are so deadly as a misguided sense of compassion.
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Copyright (c) 2001 Prison Fellowship Ministries. Reprinted with permission. "BreakPoint with Chuck Colson" is a radio ministry of Prison Fellowship Ministries.
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Four years ago, voters in Oregon legalized physician-assisted suicide. Oregon became the first state where physicians may provide terminally ill patients with a lethal dose of drugs. In the past four years, seventy Oregonians taken advantage of this dreadful law. All used federally controlled substances.
The Drug Enforcement Agency has argued that this use of federally controlled substances violates federal laws. Tom Constantine, former head of the DEA, warned doctors that they could lose their license and even be arrested if they dispensed controlled substances for something other than a "legitimate medical purpose."
Constantine was overruled by then-Attorney General Janet Reno. She prohibited the DEA from enforcing federal law in the case of doctors operating under the Oregon law. Last week, Attorney General Ashcroft did what his predecessor should have done: place the federal government squarely on the side of life.
In his memo to DEA head Asa Hutchinson, Ashcroft rejected the idea that dispensing controlled substances to facilitate suicide was a "legitimate medical purpose." He agreed with the DEA's original position and ordered its implementation.
Ashcroft's actions drew criticism from Oregon's elected officials. Senator Ron Wyden accused him of "undoing Oregon's popular will in the most undemocratic manner possible."
Oregon's governor agreed, and the next day, the state filed suit in federal court to block the DEA from enforcing the law. One day later, District Court judge Robert E. Jones issued a temporary restraining order against the DEA. On November 20, the state and the Justice Department will argue the case.
I agree with Wilberforce Forum's Dean, bioethicist Nigel Cameron, that "Attorney General Ashcroft's decision to turn the Feds loose on Oregon's killer physicians is an answer to prayer. This should nip in the bud the slow but growing move to use the prescribing of deadly drugs by doctors as back-door euthanasia."
I am sympathetic to state's rights, but not where the right to life is concerned. The Declaration of Independence is absolutely clear.
And talk about "popular will" shouldn't obscure the real issue here. What lies behind the drive for physician-assisted suicide is expediency and desire. The combination of suffering and limited healthcare resources leads us to look for an easy way out. It wasn't too long ago that one politician spoke candidly of the elderly having a "duty to die."
Polite public opinion professes to be shocked at such a thought. Still, an aging population, combined with the cost of medical care in the last year of life, makes physician-assisted suicide very appealing on an expedient basis. And all of us have that fear that we may be the ones doing the suffering one day.
But Christian ethics rises above the expedient. This is what the Gospel does. It doesn't ask what is easier, it asks what is right. Not what is, appealing though that might be, but what ought to be. Likewise, government's job isn't to cater to self-interest, it is to have the people rise above self-interest and do what is morally correct.
That's what makes Attorney General Ashcroft's decision so crucial. I urge you: sit down and write him a letter to tell him how much you appreciate his courage. And then I urge you to follow this case closely. Because our government must bring itself to side with life. One that doesn't has lost sight of its legitimate purpose.
For more information:
Press release from the Drug Enforcement Agency on physician assisted suicide ruling.
You can contact the Attorney General through the Department of Justice at or via e-mail at .
You can order a video of a debate on bioethics and physician-assisted suicide featuring Wilberforce Forum Dean Nigel Cameron from the Center for Bioethics and Culture (look under videotapes in the "resources for sale" section):
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Copyright © 2001 Prison Fellowship Ministries. Reprinted with permission. 'BreakPoint with Chuck Colson' is a radio ministry of Prison Fellowship Ministries.
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The name of Chester W. Nimitz is legendary in the annals of naval warfare. In June 1942, Admiral Nimitz commanded the U.S. forces assigned to block a Japanese invasion of Midway. In the Battle of Midway, Nimitz’s fighter-bombers caught the Japanese fleet off guard, as its carrier aircraft were being refueled on deck. His pilots swooped in and sent to the bottom four of the Japanese carriers – Hiryu, Soryu, Akagi and Kaga – that had led the attack on Pearl Harbor. Midway broke the back of Japanese naval power and was among the most decisive battles in all of history.
Nimitz’s son and namesake, Chester W. Nimitz Jr., would rise to the same rank of admiral and become a hero of the Pacific war – a submarine commander who would sink a Japanese destroyer bearing down on his boat by firing torpedoes directly into its bow.
But Chester W. Nimitz Jr., achieved another kind of fame on January 2, 2002. In a suicide pact with his 89-year-old wife, the 86-year-old hero ended his life with an overdose of sleeping pills.
Having lost 30 pounds from a stomach disorder, suffering from congestive heart failure and in constant back pain, the admiral had been determined to dictate the hour of his death. His wife, who suffered from osteoporosis so severe her bones were breaking, had gone blind. She had no desire to live without her husband.
So, as the devoted couple had spent their lives together, they decided to end their lives together. The admiral’s final order read: “Our decision was made over a considerable period of time and was not carried out in acute desperation. Nor is it the expression of a mental illness. We have consciously, rationally, deliberately and of our own free will taken measures to end our lives today because of the physical limitations on our quality of life placed upon us by age, failing vision, osteoporosis, back and painful orthopedic problems.”
According to The New York Times obituary, “The Nimitzes did not believe in any afterlife or God, and embraced no religion. But one of Mr. Nimitz’s three surviving sisters, Mary Aquinas, 70, is a Catholic nun. ... Sister Mary said that she could not condone her brother’s decision to end his life, but that she felt sympathetic. ‘If you cannot see any value to suffering for yourself or others,’ she said, ‘Then maybe it does make sense to end your life.’”
No matter the admirable life he led, the admiral’s suicide is a victory for the Hemlock Society over a sanctity-of-life ethic. From the Times’ obit, Nimitz appears to have laid aside any Christian beliefs and embraced a post-Christian moral code like the Roman Stoics who opened their veins or Japanese warriors who committed hara-kiri in atonement for the ignominy of their defeat.
Under the Christian moral code, God is the Author of life and no man has a right to take his life. The Everlasting, said Hamlet, “hath set his canon ‘gainst self slaughter.” In the Catholic Church, suicide remains a grave sin, and the admiral would have been denied a Catholic burial. But this clearly mattered far less to Nimitz than that he and his wife die in what he believed was dignity.
The admiral’s suicide is a moral tragedy. As a war hero who carried a great name, Chester W. Nimitz Jr. was a man whom it is natural to admire and emulate. Yet, many of those who read of how he ended his life will conclude that this is the course of dignity and honor for brave men. Many will take the final step the admiral took – not out of calculation, but depression, loneliness, despair and fear.
Unfortunately, we are headed for a world where the admiral’s way will be considered not only reasonable, but commendable.
By 2050, half of all the people of European descent will be over 50, with 10 percent of Europe over 80. With Christianity fading away in the West, with 60 million aged Europeans over 80 to be cared for, the course set by the old submariner will be followed by tens of thousands. Indeed, one must ask: If the admiral’s decision to commit suicide was rational, intelligent and humane, does it not logically follow that those who cannot make this decision for themselves should have it made for them by doctors who are equally rational, intelligent and humane?
A prediction: In coming decades, involuntary euthanasia will be commonplace in Europe, and Gen-Xers’ battles to stay alive into old age will be treated with the same cold contempt as they treated the silent screams of the unborn. Millions will be put to sleep like aged and incontinent household pets.
Since the 1960s, the radical young have pleaded for a world free of the strictures of the old Christian morality. They are close to getting what they have demanded ... and my sense is that they will not like what they get.
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[Original illustration at this number was a duplicate of HolwickID #31527]
CHUCK COLSON: Yesterday was the twenty-ninth anniversary of legalized abortion. Many of you marched for life. That's good. But today there's more to the question of life than just abortion. Stay tuned to BreakPoint as bioethicist and Dean of the Wilberforce Forum, Nigel Cameron, answers the question, "What comes after abortion?"
NIGEL CAMERON: Yesterday we saw one of the great events in the American calendar, the March for Life. From all over the nation tens of thousands of people, young and old, came here to Washington to say once again -- on the terrible anniversary of Roe V. Wade -- "THIS SHALL NOT STAND!"
Yet Roe seems a long time ago now. 1973 was the year before my wife and I were married, and last year we became grandparents. That truly is one whole generation, and a lot has happened since.
Do you remember the stirring movie series WHATEVER HAPPENED TO THE HUMAN RACE? with C. Everett Koop and Francis Schaeffer? I was back in my native Scotland then and was asked to organize the premier showing to Christian leaders. Those five films had one theme: that abortion and infanticide and euthanasia are all at root the same thing, the killing of human beings, and that one will surely lead to another. And, back of that, as Schaeffer never tired of saying, your worldview determines everything else. How right they were. Abortion hangs like a black cloud over our civilization. And now Peter Singer at Princeton supports killing handicapped babies. And in Oregon physicians give their patients deadly drugs, and the law approves.
Yet this year something is different. Because in the past twelve months we have seen a dramatic step that back in 1973, or '83, or even '93, would have seemed like sheer science fiction. For human beings, tiny human beings, members of our species, have been cloned. They died very, very young, before they could even be used for the experiments for which sole purpose they had been made. Like all human beings, they lived, and they died. But unlike any other human being, they were made in a lab, photocopies of somebody else -- science fiction come true.
We'll return to that later in the week. I don't want to depress you, but in a fallen world there are often depressing facts to face. The evil of abortion has crept out of the womb, just as Schaeffer and Koop said it would, to threaten all of us with euthanasia. It's now being followed by a whole new set of evils. For the biotech firms have plans for us -- patenting our genes, cloning us so they can experiment on us and use "us" in our own treatment, improving us and letting us choose what kind of kids we want to have. What Huxley called the BRAVE NEW WORLD, and C. S. Lewis the ABOLITION OF MAN, has arrived.
All of a sudden, there is a lot more on the agenda than most of us ever realized. Our march for life just got longer, the road steeper, the challenges greater than we had ever imagined.
These BreakPoints are focused on those challenges because we want to help you get the big picture and see how the parts fit together. Then you'll be prepared to play your part in defending human life against the challenges, old and new, of the twenty-first century.
CHUCK COLSON: Thank you, Nigel. This assault on the value and meaning of human life is one of the greatest threats our civilization has ever faced. Christians must be leading the charge to protect human dignity and values.
For further reading:
Dr. Nigel M. de S. Cameron, THE NEW MEDICINE (Crossway, 1992).
Charles Colson, "Can We Prevent the Abolition of Man?", an address to U.S. Congress members and staff.
C. Everett Koop and Francis A. Schaeffer, WHATEVER HAPPENED TO THE HUMAN RACE? (Crossway, 1983).
Learn more about the Wilberforce Forum's newest initiative, the Council for Biotechnology Policy by visiting .
Join the "Shake the Nation" campaign in rattling Capitol Hill by urging U.S. Senators to confirm pro-life judges. Visit .
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Copyright © 2002 Prison Fellowship Ministries. Reprinted with permission. 'BreakPoint with Chuck Colson' is a radio ministry of Prison Fellowship Ministries.
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CHUCK COLSON: Abortion's primary victim is the very, very young. But life issues go beyond abortion when the victim is old or very sick. Stay tuned to BreakPoint as my colleague, bioethicist Dr. Nigel Cameron talks about abortion for the rest of us.
NIGEL CAMERON: One of my favorite cities is Amsterdam: tulips, windmills, and a great Christian heritage that includes Abraham Kuyper, the worldview theologian of a hundred years ago who founded a national newspaper and became Dutch prime minister. But sadly in recent years, things have changed there. The Dutch have legalized all kinds of vice, and Amsterdam is as famous for its "red light" district as it is for its canals. Yet the worst legalized vice isn't drugs or prostitution. It's killing. Amsterdam is the euthanasia capital of the world.
Although it was only last year that the Dutch parliament made euthanasia legal, it has been widely practiced and condoned by the courts for the past twenty years. Who would have dreamt that the Dutch medical profession, which gained worldwide fame for its heroic stand against Nazi euthanasia during the Second World War, should now be the leading practitioner of euthanasia?
And I'm not talking about pulling out tubes or switching off ventilators. I'm talking about the kind of euthanasia that my family may need one day for our beloved 15-year-old black Lab -- the veterinarian kind: Elderly people, sick people, some not sick at all, visiting their doctor and in the office being put to death, thousands of them, and in a disturbing number of cases doctors killing patients without their consent.
Ten years ago I met a lady at a bioethics conference here in D.C. who shared this harrowing story with me. While living in Amsterdam, she gave birth to a little girl. The baby was sick, very sick, and might not live long. But her mom took her home from the hospital and cared for her. She didn't trust her doctors -- for good reason. When she had to bring her in for special treatment, she sat by her bedside.
But one day, when the little girl was back in the hospital, mom had to step out. She hurried back. And when she returned, she discovered that her baby had died. She knew because the physician met her with these words: "I didn't do it."
I don't know if he did it or not. I don't think she does either. But any society in which a physician feels he must greet the relatives of the sick by denying that he has killed his patient is in a sorry state. Belgium has just decided to follow the Dutch lead. And, of course, in Oregon we now have our own euthanasia lab.
And so we applaud Attorney General John Ashcroft for his use of federal law to seek to stop the misuse of controlled drugs in Oregon for euthanasia. He has taken a heroic stand for life.
And as we look back at Roe nearly thirty years ago, we can see that one reason for legalized abortion was that many, many Christians were asleep at the wheel. Let's make sure in the current bioethics debates this never happens again.
CHUCK COLSON: That's right, Nigel. Christians can't sit idly by when the old and the ill -- that is, the weak, the very people the Bible tells us to care for -- are killed for no crime except their weakness. Christians, this is our challenge. We must defend human life.
For further reading:
Dr. Nigel M. de S. Cameron, THE NEW MEDICINE (Crossway, 1992).
Charles Colson, "Can We Prevent the Abolition of Man?", an address to U.S. Congress members and staff.
Learn more about the Wilberforce Forum's newest initiative, the Council for Biotechnology Policy. Visit .
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Copyright © 2002 Prison Fellowship Ministries. Reprinted with permission. 'BreakPoint with Chuck Colson' is a radio ministry of Prison Fellowship Ministries.
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The story is, by now, a familiar one: A female boxer from Missouri takes a terrible beating in the ring and winds up brain-damaged. She's initially suicidal, but with the help of family and friends, she rallies, takes up painting, and speaks out about her life and the value of all life.
Wait a minute, you say: That's not how MILLION DOLLAR BABY ends. In the Academy Award-winning film, the injured boxer begs her coach to kill her because she can't face life as a quadriplegic, and he complies. But a real-life boxer, whose life story likely inspired the film, says the ending is bunk.
Like the boxer in MILLION DOLLAR BABY, Katie Dallam was a Missouri girl who grew up in poverty. In 1996, Katie began boxing. After just two months of training, her trainer urged her into a professional match and Katie stepped into the ring with a far more experienced boxer. By the end of four two-minute rounds, the referee stopped the fight, but it was too late. Katie had received 150 blows to the head and was comatose by the time she reached a hospital. Doctors told Katie's sister that she “probably wouldn't make it, and, if she did, would most likely be a vegetable.”
But Katie survived. She had to relearn how to walk and read. And her injuries affected her vision and memory. Deeply depressed, she attempted suicide. But instead of helping her sister kill herself, her sister, Stephanie, moved Katie into her home.
Unable to go back to her counseling job, Katie took up an earlier interest and began painting again.
Seeing MILLION DOLLAR BABY gave Katie nightmares. But it also led to her decision to talk with others about life after a devastating brain injury. As Katie told the NEW YORK TIMES, the fictional coach in MILLION DOLLAR BABY “took the easy way out by killing [the boxer] rather than having to deal with what her life would have been like.”
Katie's sister, Stephanie, is convinced the film writer, F. X. Toole, now deceased, based the film on Katie. Too many similarities, she says. So Katie wants to set the record straight. People, you see, can live on after terrible injuries and live rich, productive lives — people like Joni Eareckson Tada, a quadriplegic who suffered a spinal-cord injury, who also paints and has a wonderful ministry.
As Joni and Friends journalist Sanda Allyson writes, “In the face of devastating injury, many people feel they want to die. But they move from depression and feeling that there is nothing for them” into a new hope and even joy.
“We can have peace and happiness,” she writes, “in the midst of situations that might have previously been thought of as unendurable. That is just one reason why virtually all disability advocacy groups ... are so vehemently opposed to this idea of 'helping' someone die, which may sound warm and fuzzy, but in the searing light of truth, is just murder.”
So tell your neighbors that the real-life story behind MILLION DOLLAR BABY that exposes the Hollywood fiction and its values for what they are: propaganda. We can live life to the fullest, even with great disabilities, if we don't fall for the secular siren song that says that there is such a thing as a life not worthy to be lived.
The film MILLION DOLLAR BABY may have won Academy Awards, but the true-life story wins a much greater award for courage and human dignity.
FOR FURTHER READING AND INFORMATION:
• Rick Lyman, “Far from Hollywood, a Boxer Whose Dreams Died in the Ring,” New York Times, 9 March 2005. (When archived, article costs $2.95 to retrieve.)
• David Usborne, “Katie Dallam: Million Dollar Woman,” The Independent (London), 10 March 2005.
• Meredith Gould and Ruth Harrigan, “Judging Million Dollar Baby,” Godspy, 25 February 2005.
• Sanda Allyson, “'Million Dollar Baby' Cost Too High,” Joni and Friends, 4 February 2005.
• BreakPoint Commentary No. 050301, “And the Winner Is: Death, Depravity, and Dullness.”
• BreakPoint Commentary No. 050211, “Fighting for What's Important: Million Dollar Baby and House.”
• Learn about Joni and Friends, a ministry and advocacy group for individuals with disabilities.
• Peter J. Colosi, “What's Love Got to Do with It?: The Ethical Contradictions of Peter Singer,” Godspy, 25 February 2005.
• Roberto Rivera, “Lean on Me: Dignity and Dependency,” BreakPoint Online, 28 January 2004.
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Copyright © 2005 Prison Fellowship Ministries. Reprinted with permission. "BreakPoint with Chuck Colson" is a radio ministry of Prison Fellowship Ministries.
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[Original illustration at this number was a duplicate of HolwickID #27239]
She is our philosopher queen. Whenever Britain is in a royal mess over some fiendishly tricky quandary, we beseech Queen Mary for her counsel.
And so it is that we head to her palace — well, a tiny cottage in a picturesque Wiltshire village of thatched terraces — to learn what she decrees on euthanasia. For not only is Baroness Warnock our pre-eminent medical ethicist who has sat on more committees than Frankie Dettori has horses — on subjects from vivisection to special needs children — she was also a wife and mother forced to decide what to do with an ailing husband.
As medical science advances, society is left bitterly divided over what to do with the terminally ill. A judge has just allowed a sick woman to travel to Switzerland to end her life and this Tuesday parliament will debate whether to give living wills statutory force — which critics have said is euthanasia by the back door. There are no easy answers.
So I head off to ask Mary Warnock for her words of wisdom — and, it turns out, controversy: for not only does she now think assisted suicide should be legal — before she didn’t — she also feels the very frail should slink away, like elephants, to die quietly. She reckons doctors, when asked to assist in this, bang on too much about their consciences rather than their patients’ interest.
Oh, and she suggests that if parents want to keep premature babies with unviable lives on life-support machines, they should stump up the cost. Gulp.
These are bracing sentiments, but then the baroness — one of whose earlier reports led to the legalisation of embryo research — declares firmly there is no place for spiritualism [sic: spirituality] or sentiment in the law.
Over wine on a bitingly cold night by her crackling fire we mull over the dilemmas, and I feel much like generations of Oxford students in her tutorials: privileged, but nervous. For though Warnock is 80 and charming, she is sharper than a Jonathan Ross suit. Warnock explains that she has changed her public position on euthanasia because the public has changed its position.
But shouldn’t she tell us what to think rather than declare: “I’m their philosopher, I must follow them”? “I know it sounds Machiavellian, but I have come to believe in a distinction between personal consciences and public policy. If you change the law it must be enforceable.”
“People are much better informed than they were 50 years ago, so the more they are entitled to have their views heard. There is tremendous danger in thinking there are moral experts who know what is right.”
The public was moved on the euthanasia issue, she thinks, by the case of Diane Pretty, who died by suffocation as she feared she would, denied the assisted suicide she had campaigned for. “That really moved me to think we must change the law,” she says.
I agree with her wholeheartedly. I was the last journalist to interview Pretty and her husband and I came away from them wondering how anyone could look into those eyes of pain and deny them their final wish.
“She died in the way she most feared and that is appalling.”
And Warnock knows whereof she speaks. Her husband, Geoffrey, was saved at the last from a similarly gruesome death by what Mary considers a doctor’s mercy in upping his painkillers.
“He had, in the nicest possible way, been written off. He had an absolute horror of suffocation, of gradually being denied air and turning blue, similar to Diane Pretty.”
The doctor’s actions saved him from that. If it had been necessary, would she personally have helped him into the night? She struggles to answer: “Killing someone is very difficult. If I had been able to get hold of a tremendously large number of sleeping pills, I think I would have been prepared to put them in his reach. And if he’d had them I think he would have used them.”
But knowing “when is the right day” is devilishly difficult: “We watched a film together about someone having this dilemma.” Her eyes cloud over but just as she seems about to cry, she smiles roundly: “Geoffrey was very keen on golf, and before he died he was able to see the Ryder Cup and this marvellous cliffhanger, ending in wonderful victory.”
Such are the delicate balances between lives worth living, and lives worse than death. “There are still things to enjoy but it’s the dread of the future that is so awful.”
After her husband’s death in 1995, Warnock moved from the large house in the village where she and Geoffrey had raised five children, and admits for a while she “went a bit dotty”.
But since then she had done a lot of thinking and Warnock now goes further than supporting the right to suicide, as outlined in the Mental Capacity Bill; she suggests to me there might even be a duty to suicide: “I know I am not really allowed to say it but one of the things that would motivate me is I couldn’t bear hanging on and being such a burden on people. When I say that, people throw up their hands in horror, ‘This is just (the attitude) we dread if (euthanasia) becomes permissible by law; people will feel they have to do it for the sake of their family.’
“But I don’t see what’s so bad about that. In other contexts sacrificing oneself for one’s family would be considered good. I don’t see what is so horrible about the motive of not wanting to be an increasing nuisance.”
So we should be more like elephants? “Exactly, they creep off and get out of the way.” And we should show similar bravery? “Absolutely. It used to be much easier to crawl into one’s corner and die than it is now because people are always dragging you off to be rescued.” Cue: loud laughter.
She goes even further, suggesting the frail as well as the terminally ill should shuffle off early: “If I went into a nursing home it would be a terrible waste of money that my family could use far better, or even that society could use better with inheritance tax.”
This is extreme stuff. Warnock is so full of vitality, in the midst of organising a party for local artists, that she would need to be really far gone before I could see her taking her own advice. And thank God. Surely the elderly should spend what is, after all, their money on staying alive if they want to; and shouldn’t we care for them as they cared for us for as long as they are around? Not so. Warnock points out that the sick at the beginning and end of life’s cycle often rely on a limited public purse, and if we keep a baby alive on a life-support machine we deny someone else treatment:
“Maybe it has to come down to saying, ‘Okay, they can stay alive but the family will have to pay for it.’ Otherwise it will be an awful drain on public resources.” But wouldn’t this offend against doctors’ desire to keep us alive? “I don’t see why the rest of us should be sacrificed to the scruples of the medical profession. Some say, ‘But we wouldn’t like to do it.’ Of course they wouldn’t like to do it, but maybe they should,” she intones with the cut-glass determination that sent young men off to do their duty in the trenches.
Warnock suggests saving life for its own sake has become a fetish. She tells me of a gruesome story she heard from New York where a poor mother gave birth prematurely. “Nurses were desperate to break a record (and save the baby). The over-effort was all sentimentality, really. The mother didn’t want the baby, she knew she couldn’t cope, and within days of going home it was found dead, eaten by rats.”
For adults, life can also be hardly worth living but normally they can be asked their wishes: “If people now think they should have a say in the start of life — to keep a baby alive — surely they should also have a say in its ending?”
But critics point to research showing that more than half failed suicides are glad they survived. “There is no answer to that point,” Warnock concedes. “Except that (an assisted suicide) must be allowed time to change her mind.”
A problem with allowing assisted suicide is it contradicts our deeply held view that all lives are equally valuable. “I am not ashamed to say some lives are more worth living than others,” she declares. But a few years back this attitude led doctors not to treat a tramp because his quality of life was too low. “Yes, if someone else decides your life is not worth living, that is very dangerous, but the current bill would allow people to draw up living wills asking not to be revived, so it would be their own decision.”
We meet just after publication of the Shipman report. Surely this proved that it is shockingly difficult to determine whether a doctor has been merciful or murdering? “There is a real danger from rogue doctors but this bill addresses that by requiring two doctors (for an assisted suicide). It is unlikely both would want to bump her off.” As for “Mrs Z”, who was allowed to fly to Switzerland to kill herself, Warnock thinks it was right to let her go but “ there is an absurdity in saying ‘she can kill herself but not in my backyard’. Making her go abroad when she is very ill only piles on the agony.”
As one of our most eminent philosophers she has spent a lifetime pondering morality. She believes we pick it up as children from tiny incidents; learning that pulling hair is nasty leads us to conclude harming others is wrong. Her regret is that too many teachers avoid hard moral lessons: “They find it easier to tell children about the rainforest than about right and wrong. Yet little children aren’t very tempted to cut down rainforests.”
Rational argument, she believes, is our salvation. This is why she is outraged by Tony Blair hiding behind his faith. “The worst thing Tony Blair ever said was that he would be judged before his God; it was horrible.” Parliament, she says, should be his judge in the here and now, not God some time in the future.
With that bracing statement, she tells me she’s “got to clean the house before the party”. It is 9pm but she shows no sign of flagging. Let’s hope that for the philosopher queen the euthanasia dilemma remains purely theoretical for a long time yet.
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On Good Friday Jesus died as a substitutionary atonement for the sins of mankind. This is what Christians commemorate. In dying, Jesus established, as a defining mark of a Christian society, the principle of human dignity and the sacredness of life. Fallen sinners?all made in the image of God?are so precious in God's sight that He would sacrifice His only begotten Son for them.
What an irony this presents this year. Jesus died so that we could be free and saved. It was a noble death, if there ever was one. But another death occupies the headlines today, one that mocks the death of Jesus. It is Terri Schiavo who is being killed by judicial fiat. For what reason?
She is being killed so that society can get rid of a nuisance. She is being killed so her husband can be free to marry the woman he has lived with for years and who has borne his children. Her husband, allegedly, profited from the damages paid because of the medical injury to Terri. She is being killed so that medical funds can be saved.
Good Friday marks a day on which God established the principle of the sanctity of life once and for all. One man died so that all men could be free. The Terri Schiavo case marks the triumph of utilitarianism over that Christian view of life. It is victory for the likes of Peter Singer, the ethicist at Princeton, who favors infanticide and euthanasia and who argues that the governing ethical principle in life has to create the greatest happiness for the greatest number.
But no life is safe in a utilitarian society. I am seventy-three. One of these days a committee of doctors could say that I am too inconvenient or cost too much to keep alive. “It is time,” as former Governor Lamb once provocatively said in Colorado, “to do my duty and die and get out of the way of the younger generation, like leaves swept up off the streets.”
The retired folks in Florida and elsewhere, many of whom are privately thinking they really would like to keep this principle of assisted suicide intact because they may want to avoid suffering, are turning the decision of whether they live or die over to others. Do they really want to do that?
We used to say in law school, “Bad cases make bad law.” This is a very bad case. Medical data concerning Terri is old and ambiguous. There is conflicting testimony about whether she really is in a persistent vegetative state. She certainly does not look and act like she is in one. She was not being maintained on life support. She was simply being fed and receiving water as any other human being would expect. So if we can kill Terri, who is next?
Thundering out of the heavens this Good Friday come God’s words: “I have set before you life and death, blessings and curses, now choose life so that you and your children may live and that you may love the Lord your God.”
I shudder to think what is going on in the heavenly councils at this moment, as on this day of all days, black-robed judges in courts are ordering that an innocent woman starve to death. Choose life? Can anyone hear those words today?
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Copyright (c) 2005 Prison Fellowship Ministries. Reprinted with permission. "BreakPoint with Chuck Colson" is a radio ministry of Prison Fellowship Ministries.
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Thomas Jefferson never knew Terri Schiavo. But his words resonate with relevance as we reflect on the roles that the state of Florida and the government of the United States have played in trying to protect her life.
“The first duty of government is the protection of life, not its destruction,” declared Mr. Jefferson. “The chief purpose of government is to protect life. Abandon that and you have abandoned all.”
It was Jefferson who, in penning the words of the Declaration of Independence, declared that the right to life was “unalienable” because it was “endowed” to us by our Creator. Government's role, according to this revered founding father, was to “secure” the unalienable rights conferred by the Creator on His creatures.
In the hue and cry that has surrounded the controversy concerning Terri Schiavo's court-ordered death, many seem to have forgotten the role our Founding Fathers envisioned for government. There is a reason Mr. Jefferson and the founders attached such primacy to the right to life. The right to life is the “first” right. It is that right without which no other right can exist. The right to speak as one pleases, worship as one chooses or associate with those whom one prefers all depend upon the protection of the right to life. Without protecting the right to life, all other rights are meaningless. Even the “right to privacy,” which has been at the center of the Schiavo litigation, means nothing to a corpse. The enjoyment of all of the rights that derive from the Creator and which are secured by our Constitution and laws depend, first and foremost, upon protection of our right to life.
Critics of government intrusion into the acrimonious battle between Terri Schiavo's husband and her family seem to have overlooked the fact that it was Michael Schiavo who first petitioned the Circuit Court of Pinellas County to authorize the starvation and dehydration death of his disabled wife. In doing so, Mr. Schiavo is the one who injected government into the controversy. Thereafter, in proceedings that accorded her substantially fewer due-process protections than afforded death-row inmates, the court not only “authorized” Terri's death, it “ordered” her death by starvation and dehydration.
The legislature and the governor of the state of Florida acted in the finest tradition of government when they sought to intervene to prevent Mrs. Schiavo from suffering a slow, agonizing death -- one that would have been deemed “cruel and unusual punishment” for serial killers like Ted Bundy. The United States Congress and the president, likewise, acted in the finest Jeffersonian tradition when they sought to provide relief for Terri Schiavo.
The 14th Amendment to the United States Constitution provides that “no state ... shall ... deprive any person of life ... without due process of law.” The amendment confers on Congress the explicit power to enforce, by appropriate legislation, the provisions of the amendment. Thus, acting pursuant to its constitutional authority, Congress rightly sought to provide Terri Schiavo the same rights of review that are available to death-row inmates. After all, Mrs. Schiavo will be just as dead as Ted Bundy if the Florida court order is not set aside.
Contrary to the assertions of some, Congress' intervention did not offend principles of “states' rights” or “federalism.” Neither states' rights nor federalism gives a license to the states to run roughshod over the rights of American citizens. Sadly, the states have a long and sad history of giving the short shrift to the constitutional rights of vulnerable or unpopular American citizens. It is precisely because of that history that the 14th Amendment was passed in the aftermath of the Civil War.
What is most surprising about the role of government in the Schiavo case is that the courts seemed to have cast a blind eye and a deaf ear to the need to protect the rights of a frail and vulnerable citizen. Historically, courts have been a bastion for the protection of individual liberties. Traditionally, it is the courts that have been the great “equalizer” for the weak and the vulnerable and the poor and unpopular. In this case, however, and increasingly around the country, courts are becoming aiders and abettors of the strong in exploiting the weak, and accomplices of the rich in exploiting the poor.
As our country shifts away from a sanctity of life ethic and moves increasingly toward an ethos that calculates the net worth of individuals using cost-benefit ratios and quality-of-life calculus, who will protect us from exploitation and abuse when we become inconvenient or when we cost more to maintain than we produce? If not the government, who will stand in the gap?
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Ken Connor served as counsel to Governor Jeb Bush in the Bush v. Schiavo case. He is chairman of the Center for a Just Society, online at www.centerforajustsociety.org
QUESTION: Why is the church against euthanasia in instances where people are in terrible pain?
ANSWER: Let's respond to this question through the eyes of the family caring for a sick or dying loved one, because that is the context in which most of us face this agonizing issue.
We do not like to see loved ones sick, dying, or in pain. It goes against nature, moral training, and Christian faith to sit happily by when they suffer.
Our first instinct will be to try to find a way to save their lives. We will be supportive of aggressive treatment for as long as our loved one, the rest of the family, and the medical team hold out hope for a cure.
When such hope is no longer realistic and death is imminent and certain, we try to make our loved one as comfortable as possible. There will be little debate that even if the family ends now-futile medical treatments (such as chemotherapy), all reasonable efforts must be made to alleviate suffering. Beyond hoping for a miracle, all who love the dying person will pray for a peaceful death soon.
So far, so good. The question, however, seems to presuppose that this strategy is not good enough when the dying person is in “terrible pain.” At that point, it is implied, Christians are hardhearted in not supporting euthanasia.
This is a widely held view today. But it is wrong.
First we need to define some terms. Most thoughtful bioethicists or physicians accept the legitimacy of withholding or withdrawing medical treatments when they are no longer bringing benefit to an irretrievably dying patient. Nor is there any opposition to aggressive use of painkillers and other forms of palliative care.
But euthanasia is a different thing when it means (more than simply withdrawing medical treatment) ordering or implementing some act that kills a dying person: whether it is a lethal injection, an overdose of drugs, intentional starvation, or a gunshot to the head. Morally, it matters little if we do the deed ourselves, give our loved one the means to do the deed, or pay the doctor to do it. In any case, we are involved in an act that directly brings about the death of another human being.
The question is correct in implying that the church, or at least the great majority of its moral thinkers and traditions, opposes euthanasia. This opposition is based ultimately on the commandment “You shall not murder,” but is articulated in various other ways, including:
• the belief that the intentional taking of the life of a person who poses no threat to the community is a form of murder and is thus intrinsically wrong, even if it is done with good motives;
• the fear that the freedom to put to death sick or dying people is a violation of the mandate of the medical profession and would thus deeply corrupt it;
• the fear that base motives such as financial gain will interfere with the family decision-making process and lead to what is essentially sanctioned family murder of the old;
• the fear, based on historical experience, that political leaders will take over the power to kill the infirm and sick and use it to cut the government's medical expenses or advance some kind of perverse vision of the common good;
• an intuitive sense that a good and loving family, or a good and loving nation, will find some way to show its compassion to the sick and suffering that does not involve directly taking their lives.
Fundamentally, Christians oppose euthanasia because it simply does not fit with core Christian theological convictions. God is Creator, not us (Gen. 1:1). Human life is in his hands (Job 1:21). Illness and death are a tragic part of life in a sin-sick world (Gen. 3:19), and we must fight them hard — as Jesus fought them hard (Mt. 4:24). The time will come when every person's earthly life is over. At that point, our only hope lies in the resurrection promised to those who belong to Jesus Christ (1 Cor. 15:50-56).
We are called to heal the sick where we can, comfort the dying always, and entrust the dead to God. But we are never called, and we are never free, to hasten the dying across the threshold into eternity.
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David P. Gushee is the Graves Professor of Moral Philosophy at Union University in Jackson, Tennessee.
The modern push for euthanasia is a push against a two-millenniums-old Christian tradition.
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The case of Terri Schiavo, a severely brain-damaged Florida woman who has been on life support for over a decade, has reopened debate by secular and church authorities alike on questions surrounding euthanasia or “mercy killing.”
The matter is admittedly not simple. But the Christian church has, at least until recent decades, spoken on it with a fairly unified voice.
Here as in other issues related to human life and sexuality, the Roman Catholic Church has done a good job of defining and sticking by its official position. On the other hand, at the grassroots, more conservative Protestants than Catholics or any other group of Christians have taken an uncompromising position against euthanasia — to put it in the language of the Catholic Catechism, “an act or omission which, of itself or by intention, causes death in order to eliminate suffering.”
But we must make a quick distinction: Almost all Christians have set aside as a special category cases of terminal illness in which treatment is ended in the face of inevitable death. The United Methodist Church's Book of Discipline states, “The use of medical technologies to prolong terminal illnesses requires responsible judgment about when life-sustaining treatments truly support the goals of life, and when they have reached their limits. There is no moral or religious obligation to use these when they impose undue burdens or only extend the process of dying.”
In “Allowing Death and Taking Life: Withholding or Withdrawing Artificially Administered Nutrition and Hydration,” the Evangelical Lutheran Church in America classes artificial nutrition and hydration as “medical treatment,” not basic care. In cases where such treatment becomes futile and burdensome, says the document, “it may be morally responsible to withhold or withdraw them and allow death to occur.”
United States law has agreed with these positions, allowing for the cessation of “heroic measures” in cases where these measures only postpone inevitable death.
But such decisions about the artificial extension of life through medical means are not really about killing, only letting die. In cases where, as the Catholic catechism puts it, hydration or feeding amount to “disproportionate means” to sustain the life of someone who already lacks cognitive function, to omit such treatment may well not amount to a direct act of killing, but rather an acknowledgement of our “inability to impede” imminent death.
Indeed, in such cases, Christians have recognized that they are in a unique position to “let go” of God's gift of life because they understand physical death as their road to another, greater life.
However, on cases marked not by the indirect or passive allowing of natural dying processes to take their course but the direct or active ending of life, the church has, at least officially, remained unified: Christians have usually insisted that any intentional, active termination of life rejects the truth affirmed in the Catholic document Evangelium Vitae (1995), that “God alone has sovereignty over life and death.” Such acts of killing, whether “merciful” or not, unacceptably dispose of God's gift of life — over which we are not masters but only stewards.
Further, both Catholic and Protestant leaders have recognized that if we legalize such active measures to end life, we not only condone individual acts that are sinful, but we also poison the care of future patients, destroying their ability to trust their own medical and emotional support network. Any logic condoning “mercy killing,” however pure or honorable in its inception, is subject to future abuse, as medical practitioners and family members become tempted to end the lives of those whose care is taking uncomfortably high amounts of effort, time, and resources.
Even without such selfish motives, Christian critics of euthanasia point out, what happens once the door has been opened to allow criteria (say, degree of pain and suffering) by which a person may be judged justified in actively ending their own life? Those same criteria must, logically speaking, be allowed to rule similar decisions of whether to end the life of a person incapable of deciding for him or herself — as in the current case of Terry Schiavo.
The question of whether to allow active measures by which a patient could decide whether or not to end their own life is not, as we might expect, a new one brought on by advances in technology. In the classical world, suicide was considered an honorable option. Consider the decision of the founder of stoicism, Zeno (c. 263 B.C.), to drink poison in order to avoid the suffering caused by a severe foot injury.
The Hippocratic School took a different position — one decidedly in the minority, but one that eventually, in the Christian West, won the day. The Hippocratics opposed both euthanasia and abortion. Their oath states, “I will neither give a deadly drug to anybody if asked for it, nor make a suggestion to this effect.”
From the beginning, Christians have approached questions of suicide or mercy killing from the standpoint of life's sanctity as a gift from God. To end a life under any circumstance is to violate that gift, not to mention the commandment “Thou shalt not kill.” It is, as the Catholic catechism says, “a murder gravely contrary to the dignity of the human person and to the respect due to the Living God, His Creator.”
The Biblical basis for this “sanctity of life” position draws from the understanding of human life as gift expressed in Acts 17:25, the understanding of man created in the image of God found in Genesis 1:26-27, and the understanding of covenant in Genesis 9:5-6 and Exodus 20:13. The duty to respect human life appears in Genesis 9:5; 4:8-10, 15, and our responsibility for the life of fellow humans is taught in Genesis 4:9 and Deuteronomy 21:1-9.
This Christian position was not publicly questioned even in cases of severe suffering (though individual Christians, faced by such suffering, no doubt made decisions counter to this position) until the nineteenth century, when new anesthetic options made mercy killing more attractive in severe cases. The conversation started in the Victorian period swiftly ended at the middle of the twentieth century, however, in the face of revelations of the Nazis' programmatic eugenic killings.
It heated up again in America in the 1970s, when a young woman who went into a coma, Karen Ann Quinlan, survived for nearly a decade in what was called a “vegetative state.” The New Jersey Supreme Court intervened to allow Quinlan to be removed from a respirator, and concerned observers began searching for a definition of a life no longer worth living, to justify mercy killing at least in cases where the patient could make their own decision.
In the face of Christian teachings on sanctity of life, it is hard not to see this trend towards legitimizing euthanasia or mercy killing as a strong sign that we are indeed living in a post-Christian world.
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Copyright © 2003 Christianity Today
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Sermon in Current Controversies series. Job 3:11-26
CHOOSING DEATH
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I. A week of significant deaths.
II. Our society's evolving standards.
A. A series of tragic cases.
B. Dr. Kevorkian and physician assisted suicide.
III. The key issues.
A. Personal autonomy is increasingly valued.
B. Medical treatments have advanced.
C. Moral standards have shifted.
IV. What the Bible says.
A. Preference is to choose life over death. Deuteronomy 30:19
B. In the extremes of life, we can learn great lessons. Job 3
V. Christians accept the reality of death.
A. Are we favoring life only because we fear death?
B. Miracles are always possible, but always rare.
C. Be honest about your motives.
VI. Choosing the best life.
WEBSITES ON THE CHRISTIAN PERSPECTIVE ON EUTHANASIA:
http://www.christianitytoday.com/ct/2004/012/27.62.html
http://www.christianitytoday.com/history/newsletter/2003/oct31.html
http://www.internationaltaskforce.org/
ADVANCE DIRECTIVES (Living Will, for New Jersey)
https://www.legaldocs.com/docs/living_will.d/nj-livw3.mv
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While the world's attention is focused on saying farewell to John Paul II, a great man who died peacefully last weekend, the world is finding no peace in what it has done to Terri Schiavo. The controversy over the decision of judges to starve her to death is not going away anytime soon — and that's a good thing.
Many commentators are suggesting that the legal fiasco surrounding Terri was foisted on us by Christian zealots. This view is totally untrue.
In fact, the most compelling argument for saving Terri was made, not by a Christian, but by Harriet McBryde Johnson, a disabled lawyer and self-professed atheist.
First, she says, Terri Schiavo was not terminally ill. This case was not about “end-of-life” decision-making; it was about intentionally killing a disabled woman by denying her food and water.
Second, Terri was not on life support. She was simply being fed through a tube. Is this method of feeding fundamentally different from feeding someone with a spoon? As Johnson puts it, “No matter how you answer that, it has nothing to do with whether a person should live or die.”
Third, Terri's case is not about a patient's right to refuse medical treatment — not, that is, unless we call eating and drinking “treatment.” If we do, then all of us, every time we eat a meal, are acting to artificially extend our lives.
Fourth, Terri was incapable of making a decision to refuse treatment — and had never made one before. Should someone else be allowed to make decisions for her regarding the simple act of eating and drinking?
Fifth, advocates of killing Terri claim that she was unaware of her situation and thus incapable of suffering. If that's true, Johnson argues, then her death cannot be justified as “relieving suffering.”
Sixth, Terri left no living will, so her death cannot be justified on the grounds that it's “what Terri would have wanted.”
Seventh, Terri, like all disabled people, is entitled to statutory protection under the Americans with Disabilities Act. She had the right not to be treated differently because of her disability. For the sake of consistency, would we now have to deny or remove feeding tubes from everyone?
Some good can come out of Terri's tragedy. I suspect that people will go rushing to get living wills in order not to be put in Terri's position. I recommend the one found on the National Right to Life Committee's website. Terri's murder might also inspire federal legislation to protect the rights of future Terri Schiavo's — to ensure that lives are not snuffed out because they are inconvenient, because the spouse wants to inherit money, or for any other arbitrary reason. Congress should pass a Terri Schiavo law that would guarantee that the rights of the disabled, who, as Senator Tom Harkin (D-Iowa) put it, “live in the shadows,” would be protected.
Life is precious; it is made in God's image. The modern utilitarian notion that someone's worth should be judged by what he or she can contribute to society is an abomination.
Thank you, Terri, for awakening us to the duty before us: defending human dignity and the sanctity of all human life.
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Copyright (c) 2005 Prison Fellowship Ministries. Reprinted with permission. "BreakPoint with Chuck Colson" is a radio ministry of Prison Fellowship Ministries.
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Robert Destro works for the Catholic League for Religious Civil Rights. His job now focuses almost full-time on cases involving treatment given to the disabled.
One in particular jolted his conscience. A young California boy with Down syndrome needed a heart operation. But the boy's father wanted to withhold treatment. Why fix the heart value? the father asked. The boy was retarded.
Destro was outraged. “Are we going to stand by and watch this child die of medical neglect simply because he's retarded?” he asked.
Unbelievably, the state of California sided with the boy's father.
In a report a few years back, the Dutch government admitted that 1,000 persons were killed without giving consent. It was supposed to be a “voluntary” program.
American Dr. Edmund Pellegrino says that any time we deem any human life as of unacceptable quality - the infant with cerebral damage, the retarded, the chronically and terminally ill - we make that life a target for “merciful destruction” and accelerate the slide down the slippery slope to involuntary euthanasia.
A particularly chilling example of such “desensitivization” exhibited itself when Pellegrino talked with a physician from the Netherlands. “How does it feel to do euthanasia?” he asked the doctor. The doctor responded, “It's hard the first time.”
Working with the dying is a regular part of Dr. Edmund Pellegrino's medical practice. He has, at times, been asked to “assist” a patient in dying. Pellegrino's response to one such request is typical: After the patient expressed his wish, Ed sought to meet the real needs behind the request.
First, he gave the patient control over their pain relief. This patient was also feeling guilty, clinically depressed, and concerned about being a burden to others. Pellegrino treated the depression and brought in a pastoral counselor to address the guilt. He then gathered the patient's family to help them see how their response to this man's illness was aggravating his sense of unworthiness.
Once those needs were met, the patient thanked Pellegrino for not responding to his earlier request to die. “The most valuable days of my life have been the last days I have spent,” he said.
“I loved Lucky like he was my son, my little boy,” Adam Riff told USA Today in a recent report. He was not describing a next-door neighbor, cousin or nephew. No, Riff was describing his feelings for his dead dog.
Riff's quote was included in a feature that highlighted the emerging field of animal rights law. Riff and his mother are suing a Florida veterinarian for malpractice, saying the vet led to the death of their sheepdog.
The Riffs’ lawyer is seeking “hundreds of thousands of dollars” in compensatory damages for the “emotional distress” the loss of the dog has caused mother and son. For the record, the son in question is 26 years old.
It would seem reasonable to hire an attorney to sue a vet for the cost incurred in treating an animal that died in his or her care. It would even be rational to bring a suit for the actual value of the animal. But to litigate on the basis of emotional trauma and loss of companionship seems a bit much.
Surveys indicate that many Americans view their pets on par with people. According to polls, 50 percent of pet owners would “very likely” risk their own life to rescue their pet while 33 percent said they were “somewhat likely” to risk death. In addition, 31 percent said they would take the day off from work if their pet was sick, and 72 percent indicated that upon returning home they greet their pet before they greet their spouse.
I suspect sentimentality causes most pet owners to elevate the status of their pets. For some, however, it is the acceptance of evolution which views man as nothing more than a highly evolved animal. For others it is the embrace of Pantheism, a belief that god is everything and everything is god. Whatever the reason, animal rights attorneys have found fertile ground in American society for their practice.
While the USA Today report focused mainly on the area of veterinarian malpractice, it is only the tip of the proverbial legal iceberg. Animal rights law is focused on a much more ominous goal -- to elevate the status of animals to persons under the law.
The majority of animal rights attorneys want to eliminate “speciesism” from society. According to Peter Singer, professor of bioethics at Princeton University and dubbed the “godfather” of animal rights, speciesism is “the belief that being a member of a certain species makes you superior to any other being that is not a member of that species.”
Ingrid Newkirk, president of People for the Ethical Treatment of Animals, summed up speciesism this way, “There is no rational basis for saying that a human being has special rights.” She added, “A rat is a pig is a dog is a boy. They're all mammals.”
Paul Harrison, author and winner of the United Nations Global 500 Award in 1996, has said, “The Universe is divine ... natural objects are carriers of that divinity. We are part of the same family, and they [animals] are our brothers and sisters, with equal rights.”
Arguing a case of emotional distress on behalf of a lady whose dog was killed by a police officer, attorney Alan Eisenberg told the Wisconsin Supreme Court, “Times have changed. In the 21st century, I feel a companion dog is part of the human family.”
Once, animal rights advocates were regarded as part of the radical fringe. However, celebrities now champion the cause of animal equality and more than 30 law schools offer courses in animal law. Ordinary citizens now litigate on the basis of emotional distress when a pet is killed or dies accidentally.
While the goal of animal rights lawyers is to elevate the status of animals, all they actually accomplish is the devaluing of human life. Polls repeatedly reveal that the same people who move heaven and earth to save beached whales overwhelmingly support abortion and euthanasia.
If Terri Schiavo, the disabled Florida woman whose estranged husband is seeking to remove her feeding tube so she will starve to death, were a spotted owl or a kangaroo rat, she would have the support of animal rights advocates and their lawyers from sea to shining sea.
Adam Riff loved his dog like a son and he is viewed as caring and compassionate. Terri Schiavo's parents love her -- she is, after all their daughter -- and liberal activists view them as overbearing and insensitive.
When “a rat is a pig is a dog is a boy” is accepted by society, the boy's life is diminished.
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Advocates for euthanasia routinely chide opponents that “slippery slope” arguments are fallacious and irrelevant. A decision to allow euthanasia in some cases, they say, does not in fact open the door for the killing of yet others.
Tragically, however, the “slippery slope” argument is neither fallacious nor irrelevant, as recent developments in the Netherlands have made graphically clear. Once doctors are allowed to choose death over life, the resulting Culture of Death will inevitably discount human life in other contexts as well.
The latest proof of this comes in a March 10 article published in the New England Journal of Medicine. In “The Groningen Protocol -- Euthanasia in Severely Ill Newborns,” Dutch doctors Eduard Verhagen and Pieter J. J. Sauer defend the policy they established for euthanizing newborns in the Netherlands.
The infamous “Groningen Protocol” was released last year, leading to a wave of moral outrage and revulsion. Doctors Verhagen and Sauer, affiliated with the University Medical Center in Groningen, developed guidelines for euthanizing newborns. In the face of international outrage, the doctors decided to defend their policy in the prestigious New England Journal of Medicine. That journal's publication of this article marks a critical milestone in America's medical debate, and sets a chilling precedent for even more ominous developments in the future.
“Of the 200,000 children born in the Netherlands every year, about 1,000 die during the first year of life,” the doctors report. “For approximately 600 of these infants, death is preceded by a medical decision regarding the end of life. Discussions about the initiation and continuation of treatment in newborns with serious medical conditions are one of the most difficult aspects of pediatric practice.”
Thus, the authors argue that when “a medical decision regarding the end of life” is necessary with respect to newborns, policies should be in place that would allow doctors to choose euthanasia -- the willful killing of a newborn baby -- as a medically accepted practice, at least under certain circumstances.
“Suffering is a subjective feeling that cannot be measured objectively, whether in adults or in infants,” the doctors admit. “But we accept that adults can indicate when their suffering is unbearable. Infants cannot express their feelings through speech, but they do so through different types of crying, movements, and reactions to feeding.”
This debatable clinical observation sets the stage for Verhagen and Sauer to argue that infants should have a “right” to euthanasia if they are likely to experience extreme pain and discomfort, and if they face a poor prognosis and “a poor quality of life.”
The doctors advise that, in the Netherlands, “euthanasia for competent persons older than 16 years of age has been legally accepted since 1985.” That observation is true, though the Dutch began experiments with illegal euthanasia long before 1985. The so-called “Dutch Cure” has become a standard feature of medical practice in the Netherlands. “Voluntary” euthanasia is now considered a legal “right” for all those 16 years of age and older. Recently, Dutch physicians have been arguing for the age of consent to be reduced to age 12. Beyond this, what has been described as “voluntary” euthanasia has, by some reports, led to involuntary forms of euthanasia as well. The legal notion of “consent” is a thin legal principle, easily manipulated in actual practice.
Verhagen and Sauer pose the central question of their policy with clarity: “The question under consideration now is whether deliberate life-ending procedures are also acceptable for newborns and infants, despite the fact that these patients cannot express their own will. Or must infants with disorders associated with severe and sustained suffering be kept alive when their suffering cannot be adequately reduced?”
Of course, the way a question is posed largely determines the shape of the answer. The Dutch doctors frame their question with the assumption that infant suffering can, in some cases, be beyond medical alleviation or treatment.
“In the Netherlands, as in all other countries, ending someone's life, except in extreme conditions, is considered murder.” They go on to argue, “A life of suffering that cannot be alleviated by any means might be considered one of those extreme conditions.” The “might” in that sentence is critical, for this is not a universally held belief.
The “Groningen Protocol” was developed in order to protect physicians who induce the death of infants from interrogation, investigation and possible prosecution by police. Admitting that infants and newborns are being euthanized in the Netherlands, Verhagen and Sauer developed their policy to “provide all the information needed for assessment and to prevent interrogations by police officers.”
The revulsion and reaction to the release of the “Groningen Protocol” apparently surprised the Dutch physicians, who described media reports of their policy as “blood-chilling accounts and misunderstandings concerning this protocol.” But, if these doctors hoped that publishing their argument in the New England Journal of Medicine would help, they are likely to be severely disappointed.
The doctors divide seriously ill newborns and infants into three different categories. The first are almost certain to die, given unquestionably terminal diseases or conditions. Infants in the second category “have a very poor prognosis and are dependent on intensive care.” Verhagen and Sauer argue that these babies “may survive after a period of intensive treatment, but expectations regarding their future condition are very grim.” They describe these infants as characterized by “an extremely poor prognosis and a poor quality of life.”
The third category of infants are those “who experience what parents and medical experts deem to be unbearable suffering.” The doctors admit that this group of infants “is difficult to define in the abstract,” but would include “patients who are not dependent on intensive medical treatment but for whom a very poor quality of life, associated with sustained suffering, is predicted.” They offer as an example a child “with the most serious form of spina bifida.”
Note carefully that the doctors define infants in the second and third groups as those who face a poor “quality of life.” This concept is the fuse that detonates the movement for euthanasia. Doctors and other medical professionals presume to be able to determine and define an adequate quality of life for human existence. Once doctors become the quality control engineers for the human race, they can define whatever category they choose as constituting those with an inadequate quality of life, who can then be denied medical treatment or, in some cases, see their lives terminated.
“Neonatologists in the Netherlands and the majority of neonatologists in Europe are convinced that intensive care treatment is not a goal in itself,” the doctors claim. “Its aim is not only survival of the infant, but also an acceptable quality of life.” For the second category of infants, the doctors argue that forgoing or not initiating life-sustaining treatment is acceptable “if both the medical team and the parents are convinced that treatment is not in the best interest of the child because the outlook is extremely poor.”
The explicit shift to active euthanasia comes in the cases of infants in the doctors' third category. “All possible measures must be taken to alleviate severe pain and discomfort,” the doctors argue. “There are, however, circumstances in which, despite all measures taken, suffering cannot be relieved and no improvement can be expected. When both the parents and the physicians are convinced that there is an extremely poor prognosis, they may concur that death would be more humane than continued life.” That is a breathtaking assertion. These doctors argue that, if parents and physicians agree, they may choose death for an infant believed to be suffering “severe pain and discomfort.”
All this would be sufficiently frightening, but reports out of the Netherlands indicate that some doctors are killing newborns without the knowledge or consent of parents.
Even in the Netherlands, parents are not allowed to request euthanasia for their newborns, acting as representatives of their child. This poses a problem for doctors who would wish to euthanize infants. Since newborns “cannot ask for euthanasia,” and since their parents are unable to act as legal representatives to indicate consent, this poses a legal challenge. “Does this mean that euthanasia in a newborn is always prohibited?” The Dutch doctors think not.
“We are convinced that life-ending measures can be acceptable in these cases under very strict conditions; the parents must agree fully, on the basis of a thorough explanation of the condition and prognosis; a team of physicians, including at least one who is not directly involved in the care of the patient, must agree; and the condition and prognosis must be very well defined. After the decision has been made and the child has died, an outside legal body should determine whether the decision was justified and all necessary procedures have been followed.”
All this amounts to a bureaucratic rationalization for killing newborn babies. There can be no doubt that the practice of killing newborns is already a reality of Dutch medical culture. Verhagen and Sauer report that “there are 15 to 20 cases of euthanasia in newborn infants” each year in the Netherlands. Two Dutch court cases, both decided in the 1990s, ruled that physicians had met “the requirements for good medical practice” in ending the lives of infants, even though the practice is apparently illegal. Here again, the “slippery slope” is aided and abetted by courts that will not prosecute doctors who are violating the very laws intended to protect individuals from euthanasia -- much less involuntary euthanasia. In the aftermath of the two court cases, physicians requested additional guidance and guidelines. Verhagen and Sauer report that the Dutch government has failed to provide these guidelines, “despite having promised repeatedly, since 1997, to do so.”
Over the last several years, 22 cases of euthanasia in newborns were reported to Dutch district attorneys' offices. Verhagen and Sauer reviewed the cases, reporting that all of them “involved infants with very severe forms of spina bifida.”
The reluctance of Dutch courts to evaluate doctors -- even in matters of life and death -- is made apparent when Verhagen and Sauer report on these cases.
“The decisions were always made in collaboration with, and were fully approved by, both parents. The prosecutor used four criteria to assess each case: the presence of hopeless and unbearable suffering and a very poor quality of life, parental consent, consultation with an independent physician and his or her agreement with the treating physicians, and the carrying out of the procedures in accordance with the accepted medical standard. The conclusion in all 22 cases was that the requirements of careful practice were fulfilled. None of the physicians were prosecuted.”
Finally, the doctors argue that “all cases must be reported if the country is to prevent uncontrolled and unjustified euthanasia and if we are to discuss the issue publicly and thus further develop norms regarding euthanasia in newborns.” This is a clear assertion that the euthanizing of newborns should be standard medical procedure, so long as such physician-directed deaths are neither “uncontrolled” nor “unjustified.” Of course, these doctors presume that euthanasia itself is justifiable and that they possess the moral wisdom to decide when euthanasia would be “unjustified.”
Verhagen and Sauer provide two tables of data that accompany their article. In the first table, the doctors indicate that all 22 cases of newborn euthanasia considered in their study involved an “extremely poor quality of life.” Stunningly, their report also indicates that, in the case of at least 18 of these infants, a “predicted inability to communicate” was a factor in making the decision for death.
Their article also raises another frightening question. If Dutch citizens age 16 and older can request euthanasia, and if doctors and parents can agree that newborns and infants can be euthanized under certain circumstances, what about children beyond infancy but under age 16? This is not a hypothetical question, for children are also being euthanized in Dutch clinics and hospitals. Should we expect yet another “Groningen Protocol” for older children?
Verhagen and Sauer recognize that the “Dutch Cure” is considered murder by many outside the Netherlands. “This approach suits our legal and social culture,” the doctors allow, “but it is unclear to what extent it would be transferable to other countries.”
Verhagen and Sauer may be unclear about the transferability of their protocol to other cultures, but the Culture of Death is not found only in the Netherlands. Here in the United States, the logic behind the “Groningen Protocol” is gaining traction. The “Dutch Cure” now seems to be a contagious Dutch disease.
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This column was adapted from Mohler's Crosswalk.com weblog.
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Robert Orr expected that some people attending a Dallas bioethics conference might chuck rotten tomatoes at him over his view that end-of-life decisions aren’t always as morally clear as some believe.
Orr, a physician and bioethicist at the University of Vermont’s College of Medicine and “family doctor of the year” in the state in 1995, is a Christian pro-lifer and an outspoken opponent of euthanasia and physician-assisted suicide. He also is an ethics consultant who has been involved in more than 1,400 medical cases and is the clinical director of the Center for Bioethics and Human Dignity, a Chicago-area bioethics think tank and one of the sponsors of the “Cutting-Edge Bioethics: Human Life on the Line” conference at Criswell College.
But his views on artificially administered feeding and hydration -- that such treatment is sometimes inappropriate -- pits him against many pro-lifers.
Orr, referencing the temptation to nap during an after-lunch late-April session, mused, “I’m actually hoping that some of you do fall asleep this hour. Because I’m going to say some things that some of you don’t want to hear. In conversations and so on, I’ve gotten the idea that some of you have already decided on some issues that I think are not necessarily already decided.”
In the cases of persons such as Terri Schiavo -- the severely disabled Florida woman who died this year after fluids and nutrition were removed -- Orr said family members nearly always make the right decision on what the patient would have wanted regarding extraordinary life-extending treatment. But such decisions are best made at the bedside, not in the courts, he said.
Removal of artificially given food and water -- with proper family or patient directives -- is appropriate when continued nutrition extends life but does not enhance the patient’s recovery chances, Orr stated. Removal of fluids, done with constant moistening of the mouth and with pain relief, is often preferable to extended suffering for terminal patients and sometimes may be the ethical choice, he said.
Orr used a graph to explain the “trajectory of death.” Some people die suddenly (accidents or heart attacks), some die predictably (terminal illness) and others “dwindle” (as many elderly people do).
But the most complex ethical decisions arise from cases of people with chronic disease, Orr said. They spiral downward, improve, worsen, and improve again. “There’s crisis after crisis -- you never know which one will be fatal,” he said. “And so the uncertainty of how they’re going to do really colors the issue of how you make decisions in these circumstances.”
Because medicine can prolong life far more than in previous generations, new issues arose in the 1970s and ’80s along with a slew of publicized court cases that centered on medical ethics and patient and family rights.
“Some of these media cases resulted in decisions about different types of treatment,” Orr said, citing specific cases such as that of Karen Ann Quinlin, when a ventilator was removed.
“Bottom line is that it’s OK sometimes to use less than maximal treatment even if that means sometimes the patient will die,” Orr said. “This change in approach led to advance directives, hospice, palliative care -- very positive things.”
Orr cited eight ways bioethicists learned from court cases between 1976 and 1990:
1) A competent patient has the right to refuse even life-prolonging treatment.
2) Incompetent patients have the same right and a surrogate may exercise that right.
3) The family is the presumptive surrogate, except in Britain where physicians make the call, sometimes with the family’s influence.
4) Courts are inappropriate places to settle end-of-life issues.
“A judge sitting on a probate bench for 15 years may see one, two, three limitation-of-treatment cases in his or her career,” Orr noted. “They’re not used to this. They’re not up for this. They’re not prepared. They would much rather prefer these decisions be made at the bedside.”
5) There is no specific diagnosis or treatment that must be taken to court for legal approval.
6) There is no difference between withholding and withdrawing of treatment.
“That was a tough pill for some people to swallow -- old folks like me,” Orr said.
7) Artificially administered fluids and nutrition are treatment.
8) Physicians or hospitals acting in good faith and without negligence will not be held civilly or criminally liable for limitation of treatment at the surrogate’s request.
“It was painful learning those eight lessons but those are pretty well accepted in North American bioethics are this point,” Orr said.
The limitation of treatment, he said, may involve such things as cardiopulmonary resuscitation, ventilators, chemicals to maintain blood pressure, artificially administered hydration and nutrition, radiation and chemotherapy -- even transfer from emergency to intensive care.
“I’ve got some news for you. When a patient dies in the hospital, 70 percent of the time the timing of death is a matter of choice,” Orr said. “Not the fact of death but whether the patient dies now or three days from now or three weeks from now is often dependent on whether or not we try to resuscitate, give one more blood transfusion, another round of antibiotics, chemotherapy, so on.”
Withholding treatment, Orr said, is usually an advance decision on a specific remedy; withdrawing treatment is to stop something already begun.
“There’s really no professional, moral or legal difference between those two,” Orr said. “...However, there may be a significant psychological difference. It’s harder to go into the ICU and turn down the dials on the ventilator knowing that the patient almost certainly will not survive than it was to not start the ventilator in the first place.
“Why might we consider limiting treatment in certain circumstances?” Orr asked. “Well, if the patient doesn’t want it -- that’s reason to consider it. Or if it’s not going to work, or if it’s outside the burden of care, or if the burdens of risk of treatment outweigh the benefits. And can we say it out loud -- if the cost outweighs the benefits?
“I’m not saying these are definitive answers but these are considerations we must bring onto the table when we’re talking about limitation of treatment,” Orr said.
When making ethical calls, Orr said he relies on four factors -- medical indications, patient preference, quality of life and context. He said the first two factors rely on facts; the other two are not so clear.
“What is the condition of the patient? What was the baseline condition a week ago before he had this stroke and is in this condition now? And a big question is, ‘What’s the likelihood of getting him back to an earlier condition?’
“Prognosis is not a fact, it’s a guess,” Orr stated.
Orr said a patient’s preference might be discerned from the values he expresses, whether he was coerced or pressured by family, finances or physicians. Also, one must consider whether an advanced directive or living will exists or the context in which he expressed his wishes. “The piece of paper is much less important than having a conversation with the family to know their goals and values.
“Sometimes there’s a very poor prognosis and you have no idea what the patient wants,” Orr said. That’s when he considers quality of life for the patient in the context of his or her life prior to medical treatment.
“Christians get very nervous when I mention the phrase ‘quality of life’ because human life is sacred. I’ll be at the head of the line preaching the sanctity of life, but life does have its quality. We have a stewardship of life and resources,” Orr insisted.
Sometimes, monetary considerations should inform whether one should pursue extraordinary means in terminal cases, Orr said.
As for quality of life, Orr said doctors and nurses are bad at assessing it. Their perspective of a paralyzed patient who can’t breathe without a machine contrasts with the patient who seems more functional.
Orr told of being called to an ICU to decide whether to put a 53-year-old man on a ventilator who had severe cerebral palsy and mental retardation.
“My knee-jerk response was that this is a pretty poor quality of life.”
But after talking with the man’s mother, who was across the country for a family reunion, Orr said the picture changed.
“For 50 years she had taken care of him at home. When she was in her 80s she could no longer lift him and admitted him to a nursing home where she fed him twice a day.” Orr speculated the nurse didn’t know the eating habits of the man as his mother did, prompting a perceived swallowing problem.
“She said, ‘Do whatever you need to do, put him on a machine and I’ll be on the next plane.’”
A few days later Orr returned to find the mother at her son’s bed where he was communicating with her. “I could not understand one syllable, but I noticed he was looking at me and talking. She said he wanted to know what kind of car I drive.”
After Orr told the man he drove a Saturn, the man went into a monologue about the vehicle’s specifications since this was his particular interest.
“I had no idea there was anybody home. I knew that, first, I was a stranger and, second, he was sick and had a certain level of function, then got a fever and was functioning at a lower level.
“So don’t be so quick to judge the quality of life, especially when dealing with strangers,” Orr said.
Although healthcare originated as a religious service with hospitals and hospices begun by religious orders, the secularization of healthcare is nearly complete, Orr said.
“We still have chaplains, but don’t let them get in the way. God talk is excluded,” he warned.
A revival in spirituality in healthcare may open the door to talk with a patient about his spiritual life although “a lot of things under that umbrella are spirits that are not the Holy Spirit,” he said.
Orr said four non-intrusive questions help a person have a conversation about a patient’s relationship with God: Do you belong to a faith tradition? How important is your faith to you? Do you belong to a faith community? How does your faith affect your life and how I should take care of you?
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