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ETHICAL PROBLEM WITH SELF
THE ETHICAL PROBLEM WITH SELF
Subtitle: To Pull The Plug, Or Not To Pull The Plug!
Terri Schiavo's very public death by starvation has sparked heated debates that will likely resonate with political overtones for some time to come. And although much ink has already been devoted to these issues, I am prompted to enter the arena with some thoughts based upon personal experience.
Technological advances in medicine have now made possible that which was formerly impossible. Only a few years ago a stroke that rendered a person incapable of swallowing was effectively a death sentence. If they could not eat or drink, it made no difference if they were otherwise alert and functional. The only medical help that could be rendered was to give intravenous fluids and make them as comfortable as possible while waiting to see if there might be a reversal of the effects of the stroke. And with very few exceptions the patient died, but it simplified things for family and friends because the outcome was strictly in God's hands.
However, feeding and hydration of brain damaged individuals today is a relatively simple procedure. For long-term care a special tube is surgically inserted through the wall of the abdomen into the stomach itself and part of the tube--an inflatable bulb (a type of catheter)--is expanded by injecting sterile water to anchor the tube in place. Then a high-protein liquid formula is either introduced by a bulb syringe in meal-size amounts or incrementally around the clock by an electonically controlled feeding pump. This formula satisfies all nutritional/hydration requirements and patients can live for many years being fed in this manner.
I know from firsthand experience the ethical and moral problems this relative ease of treatment poses. For years my mother made her wishes known about not wanting to prolong her life if such measures should ever become necessary. And she had a living will drawn up to try to ensure those wishes were carried out. But since I am an only child and my dad preceded her in death, it eventually fell my lot to execute her wishes after she suffered a massive stroke, was rendered semi-comatose and could not swallow. So my first step was to ask the attending physician about what was usually done in such cases and how I should proceed. His answer stopped me in my tracks, because as it turned out, I only thought I was prepared to comply with my duty to "pull the plug." His demeanor was serious as he told me that death by starvation is very painful--something I did not know and had not considered. Well, to say the least, assuming that awesome responsibility put me between the proverbial rock and a hard place! But it only took me a few minutes to collect my thoughts and tell them to put in the feeding tube. Wishes or no wishes, I was not about to cooperate in helping my mother to commit what amounted to slow and painful suicide!
Now if the choice had been to put her on a ventilator long term, I would have complied with her request and refused. That is an artificial means to prolong life by forcing the patient to breathe and is totally unnatural. Plus the possibility exists that after removal they will continue to breathe on their own. Then regardless of the outcome, we must view their survival or death as being God's will. Whereas by contrast, if it were possible without strangling them, who would hesitate to pour food and drink down the throat of someone to keep them alive? That is essentially all that is done by using a feeding tube and is quite minimal as far as aiding a natural process is concerned.
Most rational adults (myself included) would rather die than be a burden on their family and there is nothing new or strange about that desire. However, medical techniques such as the feeding tube now make the odious prospect of becoming a burden statistically probable if we live long enough. And such ethically and morally difficult decisions are only going to become more and more common. And because of that fact there are some important points that need to be stressed. First of all, when anyone makes a living will and stipulates they do not want to be kept alive by a feeding tube, ventilator, etc., they are expressing a selfish desire. And it appears very few who do so stop long enough to consider the potential impact this will have upon the individual(s) chosen to carry out those wishes. The responsibility for implementation almost always falls upon someone who loves them. And if the request is carried out, that individual will have to live the rest of their days with the realization they played a key role in ending a life. While on the other hand, if the responsible agent balks at carrying out the request (as I did and would do again under the same circumstances), there is guilt associated with the non-compliance. My friends, it is a no-win situation! So think long and hard before you decide to ask someone to shoulder that load. And those who are asked should be made aware of the potential emotional consequences before they agree.
Then complicating things greatly is the cost of providing the pump, tubes, formula, and nursing care required to maintain the patient. At the time of my mother's death over two years ago the high protein formula alone cost well over a thousand dollars a month, but was completely covered by Medicare because she was old enough to receive the benefits. Also some in-home nursing care was also covered due to the fact she had a feeding tube--adding to the total cost to Medicare. And when we consider the growing number of Americans who reach retirement age each year, such costs are rapidly becoming astronomical.
Also families whose insurance will not cover the costs of long-term care are increasingly facing financial ruin when loved ones require it. And a terribly sad fact of life is that the routine of tending to the patient's needs over several years usually causes emotional and physical trauma to the caregivers--especially if it is done at home. Love always tries to do what is best, but even a mother's love can be pushed to the point of exhaustion with such situations. And when death finally comes, there is guilt added to guilt because you are relieved it is over.
So what am I trying to say? Simply that advances in medical technology have let the ethical and moral genie out of the bottle. As more and more people are placed in a position of having to make such life and death decisions, human nature will inevitably back away from opting for long-term care because they are slowly becoming aware of what it will cost the caregiver personally and financially. And in the face of such potential trauma, the decision to pull the plug and ignore ethical considerations and one's conscience is made easier. But be advised there is a terrible price that is going to be paid when this becomes commonplace. Legalized euthanasia will be the next step because medical costs will wind up being the determining factor in who lives and who dies.
What then should a believer do if faced with a gut-wrenching dilemma like that of Terry Schiavo's case? You are told by doctors that the patient is for all intents and purposes brain dead and the condition is irreversible. Yet, the body appears healthy and breathing is normal. So do you comply with their previously stated wishes (if that is the case) and "put them out of their misery" by withholding food and water? Why not just avoid wasting time and money and end it by putting a bullet in whatever is left of their brain? "Oh, but that would be murder!" Yes, it would be, but what is the essential difference between the bullet and intentionally withholding food?
"Withhold not good from them to whom it is due, when it is in the power of thine hand to do it" Proverbs 3:27 (KJV).
Perhaps the phrase "to whom it is due" could be a debatable point where this particular discussion is concerned, but I am convinced the proper and godly thing to do is to take a deep breath and disregard the consequences to self. Keep on feeding the patient and leave their life in the hands of God--where it belongs. If it is His will that they die, no amount of intervention on our part can keep them alive. But conversely, only His divine intervention can prevent us from ending that life if we are determined to do so.
Will taking that difficult stand cost you personally? In the short term, more than likely--perhaps to the point of suffering--but in light of eternity, it is the right thing to do. And then when its all over--and you know you did all that you could possibly do to care for them--it is much easier to look at yourself in the mirror each morning. So my advice is twofold: (1) think about the possibility of assuming the care of someone else and prepare yourself emotionally because there are no guarantees you will not face it tomorrow, and (2) do not make a selfish request in a living will that someone starve you to death. Asking them to keep you off a ventilator long term when there is no sign of brain activity is, in my view, altogether different. But intentional starvation by any other name is still murder. You may wind up being a burden to them, but they will not have to stand before the Lord Jesus Christ and be judged for contributing to your death.
Just pray for His will be done in all things and then trust Him through whatever comes to pass.
If you have been born again and received Jesus Christ as your personal Savior, but have been very lukewarm in your spiritual walk with Him, you need to immediately ask Him for forgiveness and for renewal. He will instantly forgive you, and fill your heart with the joy of the Holy Spirit. Then, you need to begin a daily walk of prayer and personal Bible Study.
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