I heard something on National Public Radio during my morning
run the other day that got my attention . A report on a physician-assisted
suicide bill in California stated that the proposed legislation would let terminally ill patients end their lives. That way of putting it totally obscured the
fact that such legislation would implicate physicians, and presumably other
health care professionals, in taking steps intentionally to end the lives of
their patients. Doing so would
fundamentally distort the practice of medicine from pursuing the health of
patients to pursuing their death in the name of ending suffering. At
times, ending suffering requires ending the sufferer, which is simply
not part of the practice of medicine as we know it in western culture.
No, that is not an abstract philosophical
claim, but something that arises from what doctors, nurses, and other healers
do every day. For example, when I go to
my physician, I trust that he is single-mindedly focused on my health. If he would just as soon help me commit
suicide, I would no longer trust him because his moral identity and our
relationship would change profoundly. When physicians prescribe lethal drugs or
otherwise act intentionally to facilitate the death of their patients, even upon
the patients’ request, they no longer practice medicine as we have known it.
Physicians
do not administer lethal injections for capital punishment, for example,
because doing so is antithetical to the healing art. If our society loses the unique moral identity of medical doctors,
we will lose a great deal. A serious
vocation requires developing a distinctive character through a distinctive practice. Contrary to popular trends, not everything
and everyone may be reduced without remainder to autonomous individuals serving
the desires of other autonomous individuals.
The customer is not always right, except in a depraved materialistic
society in which persons become little more than anonymous economic units or
faceless bundles of rights that serve nothing more profound than their own
immediate desires. And if the customer
is not always right, surely that is even less the case with the patient who enters
into a practice oriented toward health, not necessarily whatever the patient
desires.
As
well, physician-assisted suicide invites abuse of the elderly, sick, and dying
by those who stand to inherit their estates.
Those are often the very people playing the dominant role in influencing
the treatment decisions of debilitated patients. Likewise, it should surprise no one that
government entities, insurance companies, and health care institutions will
likely be inclined to find ways of reducing their expenditures for patients at
the end of life by encouraging lethal efforts to end their suffering and save
money from their budgets. Larger
societal expectations will likely follow such developments, causing a social
expectation for our weakest neighbors to exercise their freedom to kill
themselves. Our
most vulnerable citizens will be deemed inconvenient and encouraged to end
their suffering by ending their lives. The skills of patiently caring for the aged
and infirm will consequently diminish.
The cult of the young and healthy will flourish in the name of
liberation to the detriment of the old
and sick. No, it is not a pretty picture.
The
hospice movement, practitioners of palliative care, and others intimately
involved in the care of the sick and dying know that treatment to make
terminally ill patients as comfortable as possible is underdeveloped in American
medicine. We are fans of high tech
life-sustaining treatment, even if it is quite burdensome and makes a patient’s
entire existence revolve around medical procedures. Surely, many patients who want
physician-assisted suicide would not do so if they received appropriate
palliative care to help them live as comfortably as possible during their last
days. And if they were at home, sustained by loved
ones in familiar settings, they would be much more likely to embrace the
struggles of this last segment of their journey than they would in an
institutionalized setting with priorities other than comfort.
Perhaps
at the heart of these debates is the meaning of suffering. The dominant attitude today seems to be that
suffering is a pointless affront to one’s dignity. Well, for those formed in our increasingly
individualistic and hedonistic culture, that is not a surprising
conclusion. In stark contrast, Orthodox Christians do not
seek suffering for its own sake, but know that living faithfully in a world of
corruption will often require pain and struggle of various kinds. These challenges give us opportunities to
grow in dependence upon God, in humility, and in love for our neighbors,
including those who care for us when we are sick and weak. They are opportunities to take up our crosses, follow Christ, and grow in holiness.
Even as
we should refuse medical treatment that makes our existence simply a function
of that treatment as a false god, we
should accept care that helps us offer our lives to the Lord and our neighbors as
best we can under the circumstances that we face. For those who worship a Lord Who healed the
sick, raised the dead, and rose victorious over Hades on the third day, that
will never mean choosing death as an end in itself. It will mean, however, refusing overly
burdensome and ultimately pointless forms of treatment in order to prepare for
a peaceful, painless, and blameless departure
from this life.The more that our family members and physicians know our intentions in this regard, the better for all concerned. And the less that the practice of medicine becomes corrupted by the intentional pursuit of death, the better for all concerned, especially the patients.