Christian Perspectives on Life and death

March 25, 2009

CASE ran a very successful conference on the 21st March that sought to allow participants to be better informed about medical ethics. The conference was well attended with 100 people taking part (our maximum number). It followed a recent issue of Case magazine that focussed on the theme Living and Dying Ethically (here). There were many wonderful sessions (some of which will be posted or published in some form in coming weeks), including:

Dr Andrew Cole – Why Christians should be interested in ethics in medicine?
Dr Megan Best – Ethical issues at the beginning of life
Dr Patrina Caldwell – Medical research involving children
Dr John Dearin – End of life issues - Euthanasia
Dr Mel Cusi – Victorian Legislation on Abortion
Melinda Tankard Reist – The grief of abortion

I was challenged by every session, but the overview presented by Dr Megan Best of key ethical issues concerning the beginning of life was particularly challenging. She made the simple point at the beginning of her talk that technology has given us information about the unborn child not possible just a short time ago. One consequence of this is that we now find it easier to identify disease and abnormalities in the unborn child. This can be good, with new ways to identify problems and abnormalities prior to birth, and ways to intervene medically, increasing the chance of a successful birth and in some cases solving medical issues more easily than if they are left until after birth. Of course it also provides opportunities for parents to know things about their unborn child not previously possible. This presents parents with opportunities to terminate the life of the foetus based on judgements about identified disease and abnormalities. Hence, technology offers us new knowledge that can be used to ensure life or sadly to terminate it.

She made a simple but profound point. Medical ethics is about challenging people to consider not just what we CAN do with technology but what we SHOULD do with it. Every doctor and in fact many parents face new ethical and moral challenges due to technological developments. One of the participants at our conference was living evidence of the outcome of choices that a mid-wife and a doctor made in his life. I sat down to have lunch at the conference with a young man named Darren (not his real name) who had severe cerebral palsy. As we sat eating he suddenly said to me in words that he had to repeat three times before I could grasp what he was saying:

"What would you do if you were a doctor and a baby was born and it didn't breathe for 20 minutes."

I gulped and said:

"Darren, that's a very hard question, even for a doctor, and I have no medical training. Without knowing how long doctors wait before declaring a child brain dead, and without knowing case history concerning revival rates after 20 minutes, I guess, I'd want the doctor to keep trying to resuscitate the child until such times as they knew it would be impossible to revive him."

Darren slapped his hands together and cried out with great enthusiasm:

"That's the right answer. And you know why I know that?"

I replied, "No Darren, why?"

"Because I was that baby."

We live in an age where perfection is what people expect. Physical imperfections are air brushed out in photos, cosmetic surgery is a growth market, the perfect body seems to be worshipped, and men and women sculpt their bodies to conform to current views on the perfect look. Deformed or missing limbs must be replaced, facial features changed. Lawsuits have been brought against doctors when birth defects have gone undetected in the womb eliminating the option of an abortion.

Technology allows us to identify abnormalities and problems and correct them. It also presents parents and doctors with the opportunity to decide to eliminate life in the womb if it doesn't meet our standards of perfection. These are not the only ethical decisions to make. Every day decisions are made to treat or not treat, resuscitate or not resuscitate. Technology doesn't eliminate the need for medical practitioners to make right choices, in fact in many ways it offers far more choices. Sound medical judgements must be made, but also ethical and moral judgements. Medical practitioners face these dilemmas every day. The life or death choices made by medical staff that attended Darren's birth meant that he lived rather than died. They honoured God in the priority that they gave to his life; Darren now honours God in his life.

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