End of Life
We are saddened by the death of Terri Schiavo—sad for her and her loved ones, that they have been parted; sad for this nation, that we did not provide Terri with the latest diagnostic tests, and sad that there was no guardian free from major conflicts of interest to represent her best interests.
Drs. Verhagen and Sauer reported in the March 10, 2005, issue of the New England Journal of Medicine (NEJM) about the Groningen Protocol. This algorithm is used to avoid prosecution in the Netherlands when performing euthanasia on infants. The impetus for this protocol was not that physicians were being actively prosecuted, but that the authors felt that physicians failed to report acts of euthanasia in infants and children for fear of prosecution.
A recent article raised the issue of whether cardiopulmonary resuscitation (CPR) is currently being performed in the most effective manner.1 According to the article, many of the skills that are carefully taught in CPR classes are neglected in the stress of an actual real-life emergency. Certainly, everyone hopes that an awareness of the problem and new monitoring techniques will improve patient care. There are, however, several other aspects of CPR where ethical concerns are not adequately addressed.
Do people really want doctors to help them end their lives in times of pain and illness? To listen to the media or read the press, you certainly would think so. Advocates of euthanasia argue that if people are given a choice between dying in agonizing pain or undergoing euthanasia/physician assisted suicide (PAS), the preferred choice would be euthanasia/PAS. Indeed, few people would choose to die in agony, except possibly Jesus, as the recent movie The Passion of the Christ has so graphically re-enacted.
In a Japanese study from the Journal of Clinical Oncology, it was reported that 25% of terminal cancer patients experienced significant depression during their illness, due to multiple factors.1 Such findings prompt us to consider the ethical obligations of Christians to terminally ill patients, especially those experiencing depression.
With a scarce, non-renewable resource such as livers for transplantation, shouldn’t the individuals who receive organs be the persons who need them most? If recipients could be selected based on need, allocation finally could be divorced from onerous criteria such as social value. Since need in this context can be equated with death (if life-saving treatment is withheld), the manner in which recipients are chosen becomes paramount. On an existential level, the question may be reduced simply to choosing who should live when not all can.
The tale of Terri Schiavo began one night in 1990, with an unwitnessed cardiac arrest. Terri's husband Michael reportedly heard a noise and ran into the hallway to find his wife prone on the floor, unresponsive. Terri's electrocardiogram showed no electrical activity. She had suffered severe brain asphyxia (anoxic/hypoxic brain injury). The press has widely labeled this condition either "persistent vegetative state" or, more ominously, "permanent vegetative state."
Someone has observed that when a revolutionary group wishes to wage war on what Christians hold to be sacred, the first--and most effective--strategy is to co-opt language in the service of the cause. It is therefore not surprising that proponents of physician-assisted death routinely speak in terms of "compassion" and human "dignity." As they seek to expand their agenda both on a popular level and in the context of policy debates, the rhetoric of compassion allows them to capture the moral high ground.
The recent Schiavo case in Florida--the battle over whether or not to remove an unconscious woman's feeding tube--is not a "right to die" case. It's not about whether she should be able to remove the tube; it's about whether she wants to.