PHI 413V Ethical and Spiritual Decision Making in Health Care

George is a successful attorney in his mid-fifties. He is also a legal scholar, holding a teaching post at the local university law school in Oregon. George is also actively involved in his teenage son's basketball league, coaching regularly for their team. Recently, George has experienced muscle weakness and unresponsive muscle coordination.

 

He was forced to seek medical attention after he fell and injured his hip. After an examination at the local hospital following his fall, the attending physician suspected that George may be showing early symptoms for ALS (amyotrophic lateral sclerosis), a degenerative disease affecting the nerve cells in the brain and spinal cord. The week following the initial examination, further testing revealed a positive diagnosis of ALS.

 

ALS is progressive and gradually causes motor neuron deterioration and muscle atrophy to the point of complete muscle control loss. There is currently no cure for ALS, and the median life expectancy is between three and five years, though it is not uncommon for some to live 10 or more years. The progressive muscle atrophy and deterioration of motor neurons leads to the loss of the ability to speak, move, eat, and breathe. However, sight, touch, hearing, taste, and smell are not affected. Patients will be wheelchair bound and eventually need permanent ventilator support to assist with breathing. George and his family are devastated by the diagnosis.

 

George knows that treatment options only attempt to slow down the degeneration, but the symptoms will eventually come. He will eventually be wheelchair bound, and be unable to move, eat, speak, or even breathe on his own. In contemplating his future life with ALS, George begins to dread the prospect of losing his mobility and even speech.

 

He imagines his life in complete dependence upon others for basic everyday functions, and perceives the possibility of eventually degenerating to the point at which he is a prisoner in his own body. Would he be willing to undergo such torture, such loss of his own dignity and power? George thus begins inquiring about the possibility of voluntary euthanasia. 

 

How would each religion interpret the nature of Georges malady and suffering? Is there a “why to his disease and suffering? (i.e., is there a reason for why George is ill, beyond the reality of physical malady?)

In Georges analysis of his own life, how would each religion think about the value of his life as a person, and value of his life with ALS?

What sorts of values and considerations would each religion focus on in deliberating about whether or not George should opt for euthanasia?

Given the above, what options would be morally justified under each religion for George and why?

The function of any healthcare worker is to ensure complete recovery of the ailing patient at hand, without exhibiting any form of biased attitude while treating a patient of any religious background. Regardless of the religious faith of the specific person, the healthcare practitioner should deliver the best possible treatment to the patient. In the present case, George, otherwise accomplished legal professional has been diagnosed with terminally ill disease Amyotrophic lateral sclerosis whereby he wishes to opt for euthanasia. Considering the given situation, the report intends to offer an ethical analysis of George’s situation, in the light of the Christian and Buddhist world view.

According to the Christian worldview, sin, suffering or any form of illness emanate in the world because of the Fall of mankind. The Christians can explain the condition of George by stating that illness is the result of the sins perpetrated by mankind (Ehrman, 2000). The Bible states that “In Him (God) we live and move and have our being” and thus George’s malady can be described as part of the design of his destiny as per the plan of God. As god wills, so shall happen, and if George has to suffer, he will and he will eventually embrace death in accordance with the wish of the Almighty, the creator and destroyer of human lives (Slott, 2015). As per the Buddhist worldview, human suffering and death are inescapable parts of human existence, and cannot be taken away. George being born as a human being could not escape disease. However, the Buddhists refer to Karma, whereby the action of the past life determines the well-being of the person in future life (Chai, 2015). Accordingly, George might have perpetrated sins for which he has to atone in this life (Fendert, 2014). The Karmic cause cannot be cured until the Karmic effect is exhausted through human suffering and death.

George has been diagnosed with a terminally ill disease and the question arises how far his life can be deemed to be worthy. The Biblical scriptures clearly state the unquestionable worth of human life as human beings are stewards of God rather than the owners of their lives. God has sent each human on earth with an eternal purpose and even though the person may be dying or is incapacitated, his existence serves the purpose of God in a cosmic world (Valk, 2015). Hence, the value of George’s life does not diminish even if he may beat the point of dying. Every human life, whether suffering from ALS like George or not has an intrinsic value which cannot be taken away from him, unless God chooses to. On the other hand, although the Buddhists believe in the worth of human life even if the individual is not enjoying optimal physical or mental health, the Buddhists being agonistics, claim that life is worth living as long as the person inhabiting the body finds it worth living. According to the Buddhist worldview, if George is able to free himself completely from the selfish desires of human existence and able to feel enlightened, he can be emancipated from the pangs of human life (Jerryson, 2015). This will be done only because human life is important and suffering as per the design of any higher authority is not considered necessary here. George’s life is worthy and he is allowed to lead his life while undergoing the illness, and yet however, human existence as per the Buddhist worldview is free from any intervention from outside. Hence, the worth of George’s life lies with and within him. Hence, a man is allowed to decide the worth of his life and can be allowed to choose a course of action that suits his satisfaction. Human life here is not worthy because it is a gift of God, but because the human being chooses to attach worth to it (Cheng, 2017).

Christianity view: The people following the religion of Christianity are usually against the decision of euthanasia. They strongly believe that human beings are mended in God’s image. Even to some churches they believe not to interfere with natural death process. They have general views against euthanasia such as we should respect the fact that God is the mentor of human beings and birth followed by death is a part of life, so humans got no right to kill any person though that person insists to die (Kolade-Faseyi, 2017). The view pointing that humans are created in God’s image does not refer that humans resemble God, but has potential to survive rationally and perceive whatever is good. Following these views can help people to live the life with God’s love. Therefore, proposing euthanasia to anyone willing to die is to provide a judgement about the current situation as worthwhile which is totally incompatible with the dignity and worth of the person. Even the individual seeking euthanasia has no right to think them worthless. According to some churches, they believe that euthanasia can interfere the dying process as it interrupts the spirit that move towards God (Clements & Koenig, 2014). Christianity says that humans should be equally valued and believe that values and dignity should be measured in terms of mobility and achievements. With respect to patients with unmanaged state of life still persists as living beings so to treat worthless and let them die would be wrong. Patients with old age and physical with mental disability should also be valued in the same way. But there lies certain exceptions to some views of Christians that the rationale decisions of every human being should be respected, even in terms refusing the futile treatment thereby ending their life. The Christianity faith leads them who follow the views about treating ill people that community should be involved in caring, providing palliative care and death should be faced with honesty. Both the lay and the professional should help the ill for preparing towards death and should make themselves open in discussing about it (Brown & Dominica, 2012).           

Buddhism View:  The Buddhists do not deal euthanasia explicitly and are against the involuntary euthanasia (Cundiff, 2012). Buddhists believe voluntary euthanasia to be wrong as it demonstrates the bad state of mind causing the physical suffering into mental suffering. They believe the physical pain should be treated with mediating and proper pain killers. They even believe that to help someone end the life puts the person in bad mental state and must be avoided. According to certain Buddhist monastic law, no one should harm themselves and forbid euthanasia (Kanjanaphitsarn, 2013). Lay person who undertake euthanasia are thought to make a wrong judgement. Buddhist even believe that the ill person with take a rebirth according to their karma. Difficulty comes when voluntary euthanasia is looked as suicide. The lord Buddha even showed suicide tolerance through monks which was used as political weapon during Vietnam War (Satha-Anand 2013). In Buddhism the end of life will impact on the beginning of the new life.  So the person during their time of death should have selfless and enlightened thoughts, free from hate, anger and fear. All these views of Buddhism suggest that euthanasia is for those people who have gained enlightenment and the others should forbid it.

Moral justification in case of George related to Christianity: According the Christianity views, the life of human being should be valued as they are the creation of God, and humans have no right to view their life as worthless. Suffering from pain does not forbid the life from being valuable and should get a dignified death. So, allowing euthanasia to George would be morally not right in terms of Christianity. Even the physicians should not help or support him in accepting euthanasia as no one has the right to provide death to anybody. As it is morally not right to commit suicide, it is also not right to assist someone dying.

Moral justification in case of George related to Buddhism: Most of the Buddhists do not agree with involuntary euthanasia. According to them with respect to voluntary euthanasia, person suffering through pain should undergo mediation and pain killers to heal their physical pain which will also reduce the mental suffering. According to Buddhist view, George seeking for euthanasia is making an error in judgment and thus should be avoided. But one difficulty in their views is that the quality of next life of the person will be based on their karma in the previous life. In Buddhism, the way the life ends reflects the next life. According to them, if someone has attained enlightenment can be approved for euthanasia. So with respect to this view of Buddhism, if George is believed to attained success and enlightenment in his career, his views should be respected but with hate, fear and anger in his mind should be forbidden from euthanasia.

After considering both the world-views, it becomes clear that while the Christian worldview states the importance of human existence which endorses the value of complete submission to God’s choice, the Buddhists are still liberal enough to allow room for self-extinction of life in special situations. I believe that Euthanasia should be allowed to George. This is because he is the owner of his own body, and if he chooses to end his life through assistance via health physicians, he should be given the consent. It is the right of every human being to lead a life of dignity, while it is the duty of physicians to ensure maximum well-being of the patient. Suffering from ALS, George will lose his ability to move, speak or walk, and would be dependent on artificial systems for breathing as well. I believe what ultimately matters is the quality of human life one is leading, and George is likely to suffer from a low quality life because of incurable pain and illness. Every individual should enjoy the right to life according to most of the religious worldviews. It should be noted that George himself decides to kill himself, and this is not a case of passive euthanasia that can be regarded morally questionable as it opposes the ideals of human dignity (Pieper et al., 2016). Though a terminally ill person should not be denied basic care, he or she should be allowed to refuse treatment that might prove to be futile or unduly burdensome.

References

Brown, E., & Dominica, F. (2012). Around the time of death: culture, religion, and ritual. Oxford Textbook of Palliative Care for Children, 142.

Chai, P. C. T. (2015). Euthanasia and China: The Traditional Chinese Moral Perspective and Its Social Justice Implications. Asian Bioethics Review, 7(1), 43-61.

Cheng, F. K. (2017). Buddhist insights into life and death: Overcoming death anxiety. Athens Journal of Social Sciences, 4(1), 67-87.

Cundiff, D. (2012). Euthanasia is not the answer: A hospice physician’s view. Springer Science & Business Media.

Ehrman, B. D. (2000). The New Testament: A historical introduction to the early Christian writings. Oxford University Press, USA.

Fendert, N. E. (2014). Euthanasia in Canada: A Shambhala Buddhist Perspective.

Jerryson, M. (2015). Buddhists and Violence: Historical Continuity/Academic Incongruities. Religion Compass, 9(5), 141-150.

Kanjanaphitsarn, S. (2013). An Analytical Study of Euthanasia in Buddhism with Special Reference to the Case of Buddhad?sa Bhikkhu’s Death. International Journal of Buddhist Thought and Culture, 21, 141-154.

Kolade-Faseyi, I. (2017). The right to die: the place of religion, ethics and the law. Nnamdi Azikiwe University Journal of International Law and Jurisprudence, 8(1), 100-108. Clements, W. M., & Koenig, H. G. (2014). Aging and God: Spiritual pathways to mental health in midlife and later years. Routledge.

Pieper, J., Hijweege, N., & Smeets, W. (2016). Attentiveness to Religious/Spiritual Coping and Meaning Questions of Patients. Journal of Empirical Theology, 29(1), 78-100.

Satha-Anand, S. (2013). Question of Violence in Thai Buddhism. Buddhism and Violence: Militarism and Buddhism in Modern Asia, 175-93.

Stott, J. (2015). Christian mission in the modern world. InterVarsity Press.

Valk, J. (2015). Religion or worldview: Enhancing dialogue in the public square. Marburg Journal of Religion, 14(1).