George A. Sprecace M.D.,
J.D., F.A.C.P. and Allergy Associates of New
ZENIT, The world seen from Rome
Dealing With Death
Australian Bioethicist Reflects on Issues Involved
By Father John Flynn, LC
ROME, MAY 4, 2012 (Zenit.org).- We will all die, and how we respond to
and suffering says much about who we are, reflects Nicholas
his recent book, “Caring for People Who are Sick or Dying,” (Connor
Tonti-Filippini is the Associate Dean and Head of Bioethics at the John
Institute for Marriage and Family, in Melbourne, Australia. He was
first hospital ethicist, 28 years ago, at St. Vincent’s Hospital,
Apart from his professional qualifications, he has first-hand
someone who is terminally ill and who for many years has battled a
chronic health problems. In fact, the book contains a sprinkling of his
experiences as a hospital patient and how he lived first-hand the
or lack of, bioethical principles.
In the first chapter of the book Tonti-Filippni discusses a number of
matters regarding the relationship between patients and the health care
In one section he deals with the matter of health care principles as
in Catholic tradition.
One of them, stewardship, originated in the Middle Ages and centers on
that humans are stewards, responsible for the care of their body. This
greatly different from a worldview that sees life as expendable if it
utility. The principle of the inviolability of human life is related to
A third principle is that of totality, which sees each part of the body
existing for the good of the whole. According to this the lower
the body are never sacrificed except for the better functioning of the
person, and the fundamental faculties that essentially belong to being
are never sacrificed, except when necessary to save life.
The book’s second chapter deals with the various issues of care for
are dying. The distinction between ordinary and extraordinary means in
treatment dates back to the 16th century, Tonti-Filippini observes.
According to this, medical procedures that are disproportionately
disproportionate to the expected outcome can be discontinued. This is
different from suicide, which contradicts the natural inclination to
One topic examined in the chapter is that of resuscitation orders. When
person is suffering from a serious disease an attempt to re-start a
heart if it fails is unlikely to succeed. Attempting to resuscitate
person would mean no one could die in peace, Tonti-Filippini explained.
is also very intrusive and cardiac massage often breaks ribs,
especially in the
The author says that among the factors to be taken into account in
whether or not to issue a “do not resuscitate order” are: the patient’s
of mind and any inclination to suicide, whether the patient has all the
relevant medical information, and the judgment of the patient’s doctor.
On the matter of discontinuing food and water to patients
Tonti-Filippini is of
the view that a Catholic facility should do its best to persuade a
is refusing nutrition and hydration in order to die to change their
Turning to euthanasia, which is distinct from withholding a futile
and which deliberately ends someone’s life by a fatal treatment,
Tonti-Filippini observed that while we should indeed respect a person’s
autonomy, taking one’s life ends any opportunity for autonomy in the
Indeed, Immanuel Kant said that suicide was wrong because it involved
oneself as an object or a means to an end.
Physician-assisted suicide also contradicts the role of a doctor in
maintain life and health. If euthanasia were possible the focus would
from palliative care to that of ending people’s live.
Not for nothing, Tonti-Filippini stated, have virtually all national
organizations in the English-speaking world unequivocally rejected the
of euthanasia and physician-assisted suicide as contrary to the ethos
Respect for life
Responding to the criticism that the sacredness of human life is a
belief that should not be reflected in civil law, Tonti-Filippini
that the inviolability of human life is not only a religious notion,
recognized in international human rights law.
When it comes to people who are in an unresponsive state, the respect
lives remains intact because it is not based on the function they can
carry out, but on who they are.
Proponents of euthanasia frequently argue that carefully drawn-up
will prevent any abuses and will limit the practice to those really in
Tonti-Filippini pointed out that the experience in countries where
is legal demonstrates the contrary. There is indeed a “slippery slope”
moreover the will to live is likely to be affected by the option of
as some people will feel they should not be a burden on their families.
In other chapters Tonti-Filippini explores themes such as mental
suffering as seen from a Christian perspective, and what it means to
chronic illness and pain. Overall, the book manages to combine in a
persuasive way ethical norms and Christian principles, illuminated by
poignant personal experiences of the author.
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