Excerpts from Beyond Suffering: A Christian view of Disability ministry; lesson sixteen- Ethical Issues at the edges of life (pp.257-258)
What is “quality of life?” This rather abstract concept applies to situations in which decisions about withholding or withdrawing care from a patient are made based on his or her levels of self-awareness, reasoning, communication and activity, as well as the patient’s probability of improvement. Quality of life decisions are usually not made by persons in question, but by their physicians, their families, or at times, the courts. Thus, there is an inherent element of uncertainty and guesswork involved. There are a number of reports of people who were seriously injured and made only a limited recovery, but when they reached their final new baseline seemed to be relatively happy. If families and doctors had been asked to predict what the patients’ response to their new life would be, they would have underestimated the patients’ rate of adjustment and happiness. Observers might think that some patients have low quality of life, when the patients themselves would rate their quality of life fairly high.
This concept may also be employed in health care rationing discussions. “After all, we shouldn’t waste any more money on this person because there quality of life will be so low, anyway.” Utilitarianism, with its goal of providing “the most good for the most number of people” would typically hold this view. Another concern is: “Whose definition of quality do we use?”v This was how Nazi Germany rationalized killing mentally and handicapped patients. They maintained that the quality of life they led was not worth saving. It would be an act of mercy to kill them.
“Sanctity of life” advocates usually find themselves on the opposite end of a freewill spectrum from quality of life proponents. Quality of life advocates sometimes support abortion on demand and a patient’s “right to die.” Sanctity of life advocates usually seek to support the patient regardless of likely outcome. As was mentioned earlier, the extreme sanctity of life position holds that everything possible must be done for every patient regardless of expense in time, money or personal sacrifice.
However, many sanctity of life advocates would support removing feeding tubes from patients in persistent vegetative state, if certain conditions apply. Scott Rae, in Moral Choices, suggests that under certain conditions removal of the feeding tube is justifiable for a patient in persistent vegetative state. According to Rae, removal may be considered if: 1) the patient cannot absorb nutrients, 2) feeding is a burden greater than a benefit, 3) there is no reasonable hope of benefit, or 4) if written advance directives dictate.
Finally, on a metaphysical level, what is the purpose of our lives? Is it only to be happy, or is it primarily to glorify God and serve him with whatever means he puts at our disposal? If we answer the former, then we are hedonists, humanists, or utilitarians. If we answer the latter, then we align ourselves with the great Christian creeds of the ages.
God is eternal and sacred, so this life is sacred. The phrase sanctity of life reminds us that life is God’s precious gift and cannot be disrespected or exploited. God’s laws break down primary into two commands: 1) to love God, and 2) to love others. This phrase emphasizes the great respect that we are to show for all human life including the newly conceived, up to the aged and infirm. No lack of intelligence, creativity, or beauty an the part of the humans in question should diminish the deep respect that we owe every person simply because the are God’s creation, made in his image. In other words, there is not a human disease or disability that could be severe enough to undermine human dignity.
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