Lively Sense Of The Value Of Life example essay topic

Dr Wade Hampton 5 October 2001 Euthanasia This was billed as euthanasia a South African Perspective but it is more of a personal perspective as a Christian whose mind is directed by Christ, as a Doctor who has had over the years to face these issues and as a person committed to see South Africa prosper and be blessed. When we deal with life decisions we enter an area of mystery and when we deal in particular with end of life decisions we are in a place where we see through a glass darkly and so there is room for humility and for grace. It is easy to become dogmatic and lose sight of the real human dilemmas and the pain that these situations create so when we look at these issues we need to tread softly because in a real sense we are walking on someone's grave.? Rottweiler and vet These situations are often too heavy for us to bear and it is possible to look for easy solutions and that which might be considered reasonable for a sick dog is now being suggested for humans. Euthanasia in its literal translation means the good death, which is something we can all seek to be part of. But its meaning has been narrowed down to mean the premature termination of life Under the banner of Death with Dignity many lives are terminated before that death can be defined as good and the challenge we face as we attempt to turn back the tide of the euthanasia movement is to provide a death that is truly with dignity and good without the premature termination of that life.

We need to provide the hope and the vision to make every death truly good. So what are the central questions that we need to answer before we can deal with end of life decisions? We first need to define value, what is it that gives a life value? Is it defined in terms of function - I am a doctor does that make my life of greater value than a road sweeper? When I retire and cease to be a productive member of society does my life have less value than it does now and when I am old and my memory fading my mind wandering lost maybe in the past do I then have no value? Or is it defined in wholeness is an athlete at the height of his powers of greater value than the cerebral palsied battling to coordinate unable to walk let alone run.

If that athlete has a car accident and ends up quadripelgic unable to move does his life have no value. Or is it defined in quality of life does the life of a millionaire living in a mansion in Durban North have more value than a glue sniffing street child on Point road. Should that millionaire lose all his money become an alcoholic and end up on the street next to that child does his life now have no value? Or is it defined in guilt or innocence does the life of a nun working for the poor in the streets of Calcutta have more value than that of a murderer and rapist awaiting sentence in Westville prison? Is the abortionist's life worth less than that of the child he is aborting? Is it defined by race - we have lived through a century marred by the decision of one group of humans to consider another group as having a lower value and thus disposable Nazism and Apartheid share the same root and had the same appalling results.

It is no accident that the first society to implement euthanasia was Nazi Germany - we seem to have difficulty learning from history. There are many ways we can decide on the value and quality of a life but as people who are committed to uphold life we define the value of a life on the value set on it and that value is independent of all these variables and inherent in being a person, in being human. That raises the next question and that is what makes me a person what makes me human. Is it existence the fact of being a human being or is it dependant on sentience the ability to make moral judgements to value life as some have suggested. Rene Descartes with his often quoted saying "I think therefore I am". Does this mean if I cannot think I am not?

If we accept this view then the brain damaged the newly conceived and for that matter newborn do not qualify as humans. Is it the ability to communicate that makes me a person? I talk therefore I am, I network therefore I am, I shop therefore I am. While these views of person exclude the demented the brain damaged the newly conceived and the newborn strangely some animals such as dolphins or primates might qualify as persons under these definitions and be afforded greater protection than the excluded humans. I am a person because I am human and I have value that is inherent it flows from being human. This value is not dependant on my function my completeness my quality of life my race or my innocence or guilt.

I have value because I am human the breath of God has breathed on me and given me life and that life has infinite value. I am a person because in some way that is hard to understand, I am made in the image of God. We are in the middle of a clash between two opposing and un reconcilable world views. There is the worldview set by what Islam refers to as the people of the Book that sees these issues in the light of revealed truth our world view is centred on our belief that God exists and He is not silent, He expresses Himself, He reveals His will. This world view dominated intellectual and moral thinking until challenged initially in the so called Enlightenment 3-4000 years ago and more comprehensively at the turn of the last Century when God was declared dead and man was viewed as having come of age no longer needing the guidance of a Parent God - this was modernism. Modernism held an essentially optimistic view of man what followed was the bloodiest century in human history precipitated by the rise of modernistic ideologies such as Fascism and its twin Communism.

Disillusioned by the failure of modernism, Intellectuals came up with the postmodern view. This is a world view where truth is not a category as in this view it cannot be known and our insistence that truth is not only revealed but can be known is rejected as anachronistic. Our view is not even worth considering. These so called intellectuals view us in the same way we view people who hold the earth to be flat or those who feel that the HIV virus does not cause AIDS.

It makes it very difficult to hold a dialogue as we are committed to the idea that truth exists and is knowable post modernists do not consider truth to be knowable or relevant. Pontius Pilate was an early post modernist with his sneering comment to Jesus when faced with the truth What is truth. I come from a specific background post modern views do not have much influence in science because science operates in a binary world - something is either a fact or it is not and the scientist's role is to establish what is fact and to try to explain that fact. Postmodern views however dominate the arts and social sciences the self appointed and anointed intellectuals who generate policy and laws hold a postmodern view.

It is hard to see how morals and ethics can come out of a view that holds truth as unknowable but there are postmodern ethics and they have come to dominate all discussion of medical ethics and policy generation. This is a battle we lost be default we did not engage and so were swept aside. We must engage in this battle or face the consequences. It is difficult to engage the people who hold this view because they are not prepared to accept our premise they view our attitudes as irrelevant and outdated we are not in their view worth arguing with. This is not so big a problem because we do not need to convince them; we need to convince the public, the people who are wrestling with these issues in their lives most of whom essentially share the same worldview as us. The post modern view is held by a small but powerful minority who control the press the politicians and the arts these are the people who are forming the public mind and generate policy.

These people are slowly changing the way the public view the world and if we do not start speaking up in a generation or two our worldview will have been totally supplanted in the public mind. Why do we consider life as sacred? We hold that life as a gift of God, our life is God breathed. Gen 2: 7 "The Lord God formed man from the dust of the ground and breathed into his nostrils the breath of life and man became a living being". We hold that in some way we are made in Gods image. Gen 1: 26, 27 "Then God said, let us make man in our image in our likeness - so God created man in His own image, in the image of God He created male and female, He created them".

It is the fact that our lives are God breathed, created in His image, that gives our lives value that makes us human persons worthy of protection. This is a continuum, it starts with conception and ends with death. It is not dependant on anything other than our creation by a loving God. We will defend human life in all its forms, from conception till the God who gave life, ends it. Job 1: 21 "The Lord gave and the Lord has taken away, may the name of the Lord be praised". Only God has the right to terminate our existence, He knows the time and the place.

No one has the right to terminate another person's life. No individual no group and not even the state has that right. In particular the state should not have that right. God gives life, only He can take it. The pope's New Year message. An authentic dialogue between cultures cannot fail to nourish, in addition to sentiments of mutual respect, a lively sense of the value of life itself.

Human life cannot be seen as an object to do with as we please, but as the most sacred and inviolable earthly reality. There can be no peace when this most basic good is not protected. It is not possible to invoke peace and despise life. Our own times have seen shining examples of generosity and dedication in the service of life, but also the sad sight of hundreds of millions of men and women from cruelty and indifference have consigned to a painful and harsh destiny. I am speaking of a tragic spiral of death, which included murder, suicide, abortion, euthanasia, as well as practices of mutilation, physical and psychological torture. Forms of unjust coercion, arbitrary imprisonment, unnecessary recourse to the death penalty.

Deportations, slavery, prostitution, trafficking in women and children. To this list we must add irresponsible practices of genetic engineering such as the cloning and use of human embryos for research, which are justified by an illegitimate appeal to freedom, to cultural progress to the achievement of mankind. When the weakest and most vulnerable members of society are subjected to such atrocities the very idea of the human family, built on the value of the person, on trust, respect and mutual support is dangerously eroded. A civilisation based on love and peace must oppose these experiments, which are unworthy of man.

END OF LIFE DECISIONS ACT To regulate end of life decisions and to provide for matters incidental thereto. This act attempts to regularize the issue of Advance Directives, the so-called living will this is a statement by you prior to the event refusing futile treatment. Explain risk-better off discussing those who care for your wishes, those who will speak for you if you cannot speak for yourself. Power of the attorney. It deals with the right of patients to refuse treatment in the face of terminal illness.

This is Passive Voluntary Euthanasia. The patient dies from an act of omission. He is not killed, but is allowed to die for lack of treatment. It is your body and you can make these decisions that is free will and is a well established pillar of medical ethics. JW and blood. Does not extend to their children.

It deals with the situation where a patient has severe pain and there is a possibility that attempts to deal with that pain could result in the patient dying note that the intention is pain relief and not death. Doctors can be inhibited by the fear that an attempt to treat pain with opiates can lead to a stopping of breathing and death and so give inadequate pain relief. This is death by second effect. The intention is central - the intention here is pain relief not pain. So far so good.

It then proposes 3 options for Voluntary Active Euthanasia. This is the situation where the patient feels his life is no longer worth living and the doctor either kills the patient or assist him in suicide. Option one is the law at present this would view either act correctly as murder. It is illegal in this country and all others except Holland and the state of Oregon in the USA. Another term for this is Physician Assisted Suicide. The basis of the Hippocratic Oath is the principle "first do no harm" this eliminates abortion and euthanasia.

Hippocrates set out to separate true healers from healers who were involved in what we would call black magic these healers also cursed and killed. Quite why this should be an area considered as being within the realm of medical practise is questionable, healing and preserving life takes skill taking life requires little skill. Anyone with a small degree of coordination and minimal ethical competence can kill. Oddly this bill indemnifies incompetence against any liability for their actions. Any change to this represents a major shift in medical practice with major risks for society Option 2 is the patient and his doctor agrees to euthanasia. The act then suggests a few flimsy safeguards including the involvement of an independent doctor with knowledge of the patients' condition but in essence the doctor and the patient or even more worryingly a person acting on the patients behalf with a power of attorney make the decision and the doctor either kills the patient or helps him commit suicide Option 3 is similar but it involves a committee so it is a bureaucratic version with stronger safeguards because the process is drawn out longer but the same practical result.

This option is unlikely to be accepted as it grossly interferes with patient autonomy, which is the primary focus of postmodern ethics The primary column of the Post Modern Ethical structure is autonomy - Its my body its my choice - as opposed to the Hippocratic -do no harm. Paternalism is the greatest ethical failure in this scheme - me doctor- you patient- you shut up. The idea is that the patient should be empowered to make his own decision. I can live happily with this idea except that in a post modern world my opinion is as good as yours and to insist that certain things are wrong because they are wrong is paternalistic and therefore unethical. The next column is Beneficence the idea that the physician must be motivated by the patients best interest again per se an accepted principle but in a post modern world should the physician feel that this was a life of low quality as defined by either the doctor or the patient. Or of low value again defined purely on feeling as truth is not a category or knowable then killing the patient can be seen as a beneficent act.

The act is littered with phrases such as intractable pain unbearable suffering terminal illness - none are defined all are subjective. Lets take unbearable suffering Rheumatoid arthritis - what to you or I might qualify as unbearable suffering - may not be to the individual with the disease. Essentially as long as the physician maintains a warm and fuzzy feeling the previously unacceptable can be accepted. The third column is Non Malfiescence the no harm concept Note there is a hierarchy here, not doing harm is relegated to third place behind autonomy and beneficence.

Societal good correctly has fourth priority this is the concept that there are issues where the overall good for society overrides the needs of an individual-access to dialysis and transplant programmes. The point that we need to grasp here is that in this system there are no absolutes because there is no way of knowing what is true and so one does what feels right. It is avery 60's kind of thing - if it feels good do it - It is like the days of Noah every man did what he felt was right. The value of a life is defined by the perception of the quality of that life rather than by an innate value of life. Quality is a very slippery concept and defining quality is imprecise. As soon as you define a life's value by perception of its quality the way is open to accepting elimination off the old, the handicapped, the brain damaged the inconvenient anyone whose life is viewed as being of low quality by themselves or whoever.

In the context of this act HIV and AIDS loom large. If you view all life as absolutely sacred then these groups are protected. I do not want to dwell on the Dutch experience but I would like to highlight some of the important results of their acceptance of euthanasia. The first is the inevitability of the slide to involuntary acts: in Holland people have been euthanasia either with no consent or even in the face of active refusal in a number of cases.

The second thing that is demonstrated is the ineffectiveness of guidelines. Guidelines were either ignored or subverted and essentially decisions were made by the patient and doctor and in some cases the doctor alone. Where the guidelines were ignored totally no sanction was applied. The third thing that has occurred is a breakdown of trust between patients and doctors. cf Saskia Trust is basic to the physician patient relationship. One does not even have to legalize euthanasia for it to have an effect, acceptance of the culture of death within medical practice has that effect-Australia bowie and donor medical ert. One only has to look at the case of Dr Shipton to see that the power over life and death is not good for doctors.

The greatest murderer in history approximately 300 deaths in a country where euthanasia is illegal. Dr Shipton would get up in the morning and decide who was going to live and who was going to die. The assumption is that doctors in some way are not like other people that they function on a higher moral plane. Doctors are human and are driven by the same emotions and desires as anyone else and their decisions can be affected by those emotions and desires. So that it is possible for doctors to make decisions that have more to do with their desires and needs than that of their patients. The parallels with the situation faced by Hippo crates are striking.

One suggestion made to cope with the acceptance of a death culture in medicine is to separate off killing facilities from life facilities. The worst effect of the acceptance of euthanasia is that pressure is applied to the elderly. A group who are particularly vulnerable {where there is a will there is a relative}. In the background hover the health care fenders. On average we spend 90% of what we spend on health care in the last two years of our lives - western societies face a demographic nightmare of increasing numbers of old people with decreasing numbers of younger people to support them - the triangle has inverted.

Widespread acceptance of Euthanasia would represent a massive saving to fenders and is thus attractive as a practical solution to unscrupulous legislators. This is a bad piece of legislation, which like the abortion act is being slipped in. This is legislation by stealth, a miniscule minority has mainly driven it: the SA Voluntary Euthanasia Society. This is a process driven worldwide by a group of middle class individuals The sort of people referred to by Paul as being without hope and without God a spoilt minority from the most pampered generation in human history. At the base of this movement is fear, hopelessness and the demand to control even death. Euthanasia movements do not originate in third world countries with low and declining life expectancies.

This is not a relevant debate for people living in countries where survival is a daily battle. It is the latest attack on the value of life and as such is ultimately satanic. The people driving this do not have horns and a tail, they are not necessarily evil; they are mainly misguided and without hope. Some are really well meaning sensitive caring types. It is not our business to condemn them but we do need to speak truth to them ideally in love. Case Scenarios - A recent survey showed that a majority of South Africans support the idea of euthanasia but I would like to know what was the question?

Let us look at some situations but more than look place yourself in this bed, put your son husband in this bed. Futile Treatment- Case: 70 year old lady with intestinal obstruction found to be due to inoperable cancer - Do you ventilate dialyses etc. We all fear ending up on a life support machine with no real hope of recovery and if the question was set on this sort of situation I am not surprised it had majority support because, if l ever end up in this situation, I would hope that those involved in my care would have sufficient respect to let me go if there was no reasonable expectation of recovery This is the classical passive euthanasia situation and no problem as death still remains in a sense in Gods hands patients have recovered after cessation of active treatment [Roseveare]. As long as the patients are comfortable and their pain controlled this is not murder and in fact the act is one of respect for life. Case 2: l 8-year-old MY A brain damaged on a ventilator Scan shows that damage is so extensive that recovery of function is highly unlikely.

Again we are in an area of futile treatment and the correct thing to do is to terminate active life support. Note we are not terminating the patient we are stopping active treatment, death is the expected result but it is not by active intervention. This is an important distinction and the moment of death remains in God's hands. Case 3: let us assume we terminate life support and he continues breathing but does not regain consciousness. This is the worst-case scenario and the one that generates the most controversy and pain.

With tube feeding and good nursing these people can live for years. Not able to move, incapable to do a single thing for themselves, unable to communicate their feelings, unable to hear or feel the pain of those that they love or be comforted by their love. This is a truly horrific situation and we need to imagine how it would feel if this was your beloved son or husband we need to walk alongside those that love that son or husband. Fortunately this is a rare event but the pain generated by these situations cannot be imagined and is hard to bear. This is the Rottweiler situation.

It is too damn heavy to bear. In the normal course of events these people will develop pneumonia and as long as they are not actively treated will die naturally. Pneumonia was referred to as the gentle killer before the invention of antibiotics and as long as the patient is kept comfortable is not a bad way to go. However the pressure to actively intervene prematurely is enormous and emotive and as a result these cases have generated a large body of legal actions. Clarke vs. Hirst. There have been a number of decisions that have suggested the solution is to stop feeding and fluid and then let starvation and fluid depletion to kill.

This can take days to weeks and it is something none would do to a dog let alone a human no matter how devastating their situation is it would be more acceptable to actively kill the patient with a lethal injection than slowly starve him to death. One of the many bad things in this bill is the definition of food and water as treatment. A court order ordering the cessation of active treatment could be used to enforce starvation of a human. One of the problems is that we assume that there is no feeling here but we cannot absolutely know. The diving bell and butterfly: Jean Dominique Bauby This is a truly inspiring book.

Jean Bauby was the editor of the French version of Cosmopolitan. He suffered a stroke and was left fully conscious but unable to move. To all appearances he would have looked no different from this young man this state is known as the locked in syndrome. After a while he regained control of one eyelid and in a remarkable story with the aid of a speech therapist wrote a book communicating with one eyelid. He looks back on meals he had enjoyed, women he had loved, places he had been and reflected on his condition. - By any definition we would offer he had a poor quality of life but if you read the book you will find that apart from the daily frustration and discomfort of his existence he relished life.

This is a different situation to the one outlined but the pressure to euthanasia here would be as great as with the other. While it is unacceptable to get a court order to starve it is equally unacceptable to get a court order to actively treat pneumonia both show a lack of respect for that person -We need to be sure to be fighting the right battle. Jean Dominique Bauby contracted pneumonia and was allowed by his carers to die with dignity. Case 4: we now start entering the area of VAN the situation here is of incurable Cancer with nerve involvement and pain.

This is another of the situations that would lead the public to support this legislation. To be in pain with no hope of recovery or treatment of that pain inevitably leads to the desire for death. WTA people jumping. Another ill defined term is intractable pain, this implies pain that cannot be relieved. While it is a fact that the medical profession has failed to treat pain adequately there is no pain that cannot be relieved with the correct methods and the will. Patients arriving at a hospice often have the desire to be euthanasia but once it is explained that they will not be allowed to die in pain and alone these desires and fears recede.

The challenge for us and for medicine is to provide the facilities where pain physical and emotional is dealt with and patients can truly achieve a good death. Palliative medicine is a new speciality that deals with these situations. Euthanasia is a cheap and nasty solution to the problem of terminal illness and pain. Legal ising abortion was offered as a solution for the catastrophe of illegal abortions.

Euthanasia will be offered as the solution to pain and terminal illness. Supporting and helping in your local hospice is a way to practically challenge the death culture in your society. One true thing is a movie that sensitively deals with these issues we may not like its conclusion but it does face the issues honestly and for those of us who have not faced these situations it does give insight into how it would feel. Case 5: Depression in the elderly - My father in law 5 years ago decided to visit his family in England for the last time - the stress precipitated an attack of acute depression that led to admission to a Victorian mental institution - he took 2 years to come right on treatment.

This year he decided to do the journey again against everyone's better judgement. It was amazing he saw everyone he needed to tie up all the loose ends. He returned in triumph. The point of this is that if he had not been treated by ethical doctors with a commitment to life and he had been offered and been encouraged to consider euthanasia in the depths of his depression it is possible he would not be here -his triumphant progress could not have occurred and his children and grandchildren would have been deprived of his enriching presence in their lives.

The elderly are particularly at risk from this legislation as they are a group who can easily feel that they have limited value and that their quality of life is low they are particularly vulnerable to pressure from the unscrupulous be it relatives or doctors. Depression is a condition that can be alleviated with enough effort. Terminal illness is another ill defined concept in this legislation - Diabetes is a terminal illness Rheumatoid arthritis is a terminal illness. Life can be viewed as a terminal illness basically anything qualifies. There is no obligation placed on the doctor to get the diagnosis correct or deal adequately with reversible conditions such as depression and pain - its worth pointing out here that most of the people killed by Jack Kevorkian were found on further investigation not to have been suffering terminal diseases.

It is the measure of a civilisation how they care for the most vulnerable members of their society. The elderly require our support and care, they need to be protected. As people committed to the value of life we must support and affirm the older members of our community. If we want to nurture a respect for life we will not stand by while babies are being killed we will not allow the elderly to be slaughtered the handicapped eliminated but also we will not stand by as I in 10 children in Trans kei do not reach the age of one year for the lack of adequate nutrition. We will not accept that half our population have to be unemployed without the dignity of a job with no form of social security to support them we will support those living with the HIV virus and not be concerned with how they acquired it. We will care for their children when they no longer can.

We will not walk by on the other side of the road from the children existing on our streets. We might consider removing the bring back the death penalty stickers from our cars. We will comfort those who mourn and walk alongside those who enter the valley of the shadow of death. Support for the sanctity of life is not limited to combating abortion and euthanasia it is ultimately about embracing and supporting life in its complexity and its pain and South Africa provides limitless opportunities to make a difference and lead a truly significant life. So be strong and courageous for the lord our God is with us.