Euthanasia: A Response. By Jennie McLaurin

In his recent blog post on euthanasia, pastor Kerry Bender wrestles with the conflicting emotions he feels as he contemplates his father’s demise from Alzheimer’s. Kerry asserts that belief trumps feelings, even though he recognizes belief is shaped by both feelings and intellect. For him, belief in God, resurrection, and image-bearing stay any impulse to hasten his father’s death through human manipulation.

Bender goes farther than many when he decides to treat his father as if he were a person, even a parent, despite the loss of any relationship between them other than the historical. Even so, many people can treat their loved ones, and themselves, as a person and even an image-bearer, but still argue that euthanasia is a viable option (pun intended). Of course, there are different types of euthanasia, passive or active and involuntary or voluntary.

The laws in the US are concerned only with the permitting voluntary euthanasia, typically in an active form. That is, the person who is the patient must make a fully informed consent to die. Not only that, but someone must give assistance so that the death is actively hastened—pull the plug so to speak, or tender the poison.

What many anxious relatives don’t understand, whether they are from a faith-based worldview or not, is that human beings are endowed with mechanisms that soften and hasten death as suffering and demise reach critical levels. Many elderly patients will turn to a wall and refuse to eat or drink as they resign themselves to dying. Is this voluntary passive euthanasia? Technically, yes. Should we force the terminally ill, whether from dementia or cancer, to be fed and hydrated? Not when it actively suspends their natural dying. And yet, as more people spend their last days in institutional settings and fewer of us have witnessed an “ordinary” or “natural” death, we are increasingly uncertain of how to respond.

In the case of Kerry’s father, most physicians would find it reasonable to limit antibiotic use for infection or to avoid any invasive feeding such as intravenous or nasogastric. Certainly, “DNR” as Kerry mentioned, would be appropriate and not at all within the realm of euthanasia. There are lots of very good indications for deciding a DNR order is reasonable, including a proactive stance related to one’s own dementia.

Personally, I do not support any of the US euthanasia laws, mostly because the evidence used in creating the laws is simply unfounded. Supporters always cite pain and suffering as intractable concerns. But the data I’ve seen suggests that those who do choose suicide (self-death, ie: active voluntary euthanasia) typically have accent to decent pain management, adequate financial resources, and uncomplaining family members. In 100% of those taking their life under WA state law, autonomy was the reason recorded. The person did not want to lose their autonomy—even if that autonomy culminated in the ironic act of ending one’s life.

Autonomy is an odd concept and one that our society seems to think little about in any meaningful way. Autonomy is one of the four primary principles of Western bioethics. But what does it really mean? Certainly we support the patient’s right to choose their care, their participation in research and their informed knowledge of options in a context of justice and beneficence. The German Holocaust and American syphilis experiments are two horrible reminders of why autonomy has come to be prized. But today’s application of autonomy in cases of euthanasia far exceeds these initial ideas about protection of the weak or vulnerable.

Today, characteristics such as “strength” and “invulnerability” are regarded as near synonyms to autonomy. In this strange reversal, autonomy is used as a shield against human interdependence. Holding onto self-power, even if it destroys oneself, is lauded as better than accepting and yielding to the care of another, particularly in humiliating, bodily ways.

Sadly, this idolization of autonomy is in fact a deep cut in the fabric of what it means to be truly human, or—in the language of faith—what it means to be an image-bearer. Rescinding our finite bodily presence in all its manifestations, refusing community and the risk of being intimately known by others, rejecting brokenness and uncertainty and grief; this is in fact an abdication of what it means to live, even now, as a Trinity-bearer.

Who is most at risk with all this language of autonomy? It is still the weak and vulnerable. We haven’t really bettered their position in this new era. We have so little tolerance for what seems a prolonged disability or worse, a “futile” form of life. Our position on autonomy is a judgment on the worth of our society’s weakest members. And I believe—to use Kerry’s words—that it is only with a renewed sense of community, of humility, and of mystery that we might approach death with dignity.

 

Wednesday, November 7th, 2012 Blogs

2 Comments to Euthanasia: A Response. By Jennie McLaurin

  • kbender2011 says:

    Jennie, thanks for the well written response. I love the conclusions that you draw regarding autonomy. I would agree that autonomy is one of the idols of our current age. It is honored and worshiped to the point of idolatry. Other than a lack of clarity on my part which I appreciate you pointing out, however, I am not sure that we disagree.

    I meant to speak to specific slice of the issue of euthanasia; unfortunately the title assigned to the post did not reflect this, and I was obviously not as clear as I should have been in my writing. The specific slice of the euthanasia controversy I was attempting to address was the “right to die” laws such as the one on which Massachusetts voted yesterday which you also do not support according to your response.

    I was not intending to address passive euthanasia as defined by “the suspension of extraordinary medical treatment.” I have watched this many times as a pastor sitting with families who watch as a loved one passes from this life to the next. I do not view this as the hastening of one’s death “through human manipulation” as you seem to be led to believe from the first paragraph of your response; rather I would agree that it is allowing the natural process of death to proceed. I don’t believe there is anything in my post that explicitly states this, but I should have been clearer, and I feel badly for not being so. The next time I attempt a blog on a medical issue, I will have the good sense to have you read it before posting it.

    I do have one question regarding your definition of “euthanasia.” You state in your response, “Many elderly patients will turn to a wall and refuse to eat or drink as they resign themselves to dying.” Then you ask, “Is this voluntary passive euthanasia?” Your response to this surprised me; you state, “Technically, yes.” I have to admit that I do not have a medical dictionary in my office, but the most common medical definition that I could find on medical websites when preparing my post was the following:

    The act or practice of ending the life of an individual suffering from a terminal illness or an incurable condition, as by lethal injection or the suspension of extraordinary medical treatment.

    Even the most modest definitions that I could find discuss the withholding of common treatments such as antibiotics but none of them said that not force feeding someone or not using a feeding tube was considered passive euthanasia. Am I mistaken on this point?

    One final note, the DNR (do not resuscitate) order in my post to which you refer in your response, was referring only of the tattoo that I jest I would get — NOT to a DNR for my father. I think a DNR tattoo is ironically humorous in a macabre way. I do not think, however, that DNRs are joking matters. I have one; I have encouraged my parents to do the same; and I speak often to parishioners about their importance.

    Jennie, thanks again for your response and bringing clarity to this issue as well as my own article.

  • jamclaurin says:

    Thanks Kerry!
    I was fully supporting your post–I don’t find any point of disagreement, and was just asked to read and comment. I hoped I was just broadening the view from your personal story to a wider conversation on euthanasia.

    regarding turning to a wall–technically, it is indeed voluntary passive euthanasia. Voluntary–the patient chooses. Passive–nothing is done actively to hasten death (lethal injection would be active not passive). Feeding tubes are active agents against death. Lack of feeding tubes is passive. Passive is that you are letting nature take its course given the lack of extra work to keep someone alive. There are many technical examples of voluntary passive euthanasia and we often are OK with them. It is just that lay folk think of the term euthanasia as always “mercy killing” when it is not really that given the passive stance.

    Kerry, you obviously care deeply and well for your father. I want to support that and am sorry if any other interpretation surfaced.

    Also–there are a few typos! I didn’t say “inalienable”. That was meant to say something like “valuable” or “necessary”. (related to autonomy). Anyway, thanks Kerry and Blessings. Jennie

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