https://www.youtube.com/watch?v=44Xy5i73240 Biola Lecture/Discussion on Assisted Suicide

Read: Paul Chamberlain, Final Wishes: a cautionary tale on death, dignity and physician assisted suicide. IVP, 2000.

Edward J. Larson & Darrell Amundsen, A Different Death: euthanasia and the Christian tradition. IVP, 1998.

Response by Dr. Bert Cameron, former head of Nephrology at UBC,

To: GFCF ‘Dying with Dignity’ Lecture-Discussion by Dr. Jeffrey Greenman, Regent College

 

Rejoinder: “I was asked to give this response by the GFCF committee. I realize that it is not a fully considered document and that I would appreciate input particularly from those experienced in current palliative care.” ~Bert

I thought Jeff did a good job. Using the video clip as a beginning focused attention well and gave him the opportunity to make a number of significant points. First, ethical problems are always difficult because they involve a conflict of principles such as personal autonomy vs. sanctity of life. Second, the use of terms such as “maturity” and “death with dignity” are slogans that  need better definition since we all want to be mature and respect the dignity of the human person.

I also thought that it was good to review the current legal grounding of Canadian laws (sanctity of life) and to point out the Hippocratic tradition and to give the Judeo –Christian basis for respect for human life, particularly the statement to Noah linking the prohibition to human murder with the image of God.

I thought the discussion was interesting, particularly the input from two doctors deeply concerned about euthanasia. They have been very vocal in the pro-life and euthanasia prevention movements. Clearly experience has shown them that when discussing this issue in society at large, the only argument likely to gain purchase is that of protection of the vulnerable in society.  For this reason, much of their attention is focused on the “bad outcomes” in jurisdictions where euthanasia is practiced in the US and Europe. This moves the discussion away from principles to anecdotes and social research.

However, I think it is important clarify our interpretation of the principles so that we are honest about them. Let me explain.

It is true that the Old Testament lays the foundation that man is in the image of God and therefore human life is to be respected. Murder is condemned. However, taking life is not condemned since death was the punishment for murder and a number of other  misdemeanors.  Therefore, the active taking of life was not prohibited in Jewish society. The death penalty was recommended for thirty or more circumstances, which included a variety of sexual, familial, religious and legal misdeeds, some of which would be considered quite trivial today. In fact, our society seems to have a higher view of the sanctity of life than is evidenced in the Old Testament such as banning the death penalty.

Therefore, though as a Christian, I believe in the respect for life based on being made in the image of God, I find it difficult to suggest that hastening the death of suffering person who will die shortly can be equated with murder from the Old Testament perspective.

Other than the general principle of respect for human life, I find little in the Old or New Testament that bears significantly on the issue of palliation as medicine is practiced today. The argument that God determines our death is applicable in a general way but not specifically in a society that prolongs life by artificial means.

The point about the Hippocratic Oath and Tradition also has to be taken with caution. The Hippocratic Oath was a pagan oath that applied to a small group of doctors in ancient Greece. They were, in essence, setting standards for themselves in order to attract patients. Since they had access to killing agents, it was a promise not to use them. Again, it has very little to do with the current discussion. The Oath was, however, taken up by the Medieval Church and “sanctified” and has been used largely because it was in line with Christian thinking and the prohibition against murder.

As far as Canadian law is concerned, it is of course under continual change. It is probable that some sort of euthanasia will be legalized in Canada because the law has increasingly been moving to support the principle of consent and autonomy over other considerations. For example, the law against treating Jehovah’s Witnesses with blood transfusions against consent even though lack of treatment will lead to death.

Further, there are a number of practical issues involved in this complex discussion. There is a wide range of individual and family response to dying. At the end of life, some want to die, some want to live at all costs. Families are also very diverse on this issue. What constitutes medical care or negligence? Is it mandatory to put an IV into an unconscious dying person? What limits are permissible to ease suffering? Every individual case is different and often not predictable. In my experience, after each case the questions often remain as to whether the best was done.

So where does this bring me?

First, I believe that modern medicine and care is rooted in the Christian tradition, beginning with the healing ministry of Christ. It is based on Jesus care for the physical ailments of humans. Subsequently Christians cared for the sick, built hospitals and universities that cared as well as producing medical advances.

Second, death is inevitable and in some cases, overzealous attempts to preserve human life should be avoided. Having said that, this is very much a judgment issue.  I have been forced, under legal threat, to keep brain dead people physically alive.

Third, within a palliative care context, wherever that is taking place, the health care team needs to be given latitude to deal with each case and family in a very individual and caring way. If this were understood and practiced, I think many situations like Dr. Lowe’s could be avoided.

Fourth, I like the phrase that Eric Stephenson mentioned to me; instead of using the term “Do Not Resuscitate” we should say “Allow Natural Death”.

Fifth, the Christian approach to the euthanasia debate should definitely focus on protection of the vulnerable. In our socialized society this can be a complex issue since we all pay for the extension of life through highly technological means.

Sixth, the question of having doctors responsible for euthanasia outside of the palliative care context is a very vexed question. I think medical societies should stand against it because it will reduce trust in physicians.

~Dr. Bert Cameron, former Head of Nephrology, UBC (professor emeritus)