George A. Sprecace M.D.,
J.D., F.A.C.P. and Allergy Associates of New
London,
P.C.
www.asthma-drsprecace.com
==================================================
ZENIT, The world seen from Rome
News Agency
==================================================
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
illness
and suffering says much about who we are, reflects Nicholas
Tonti-Filippini in
his recent book, “Caring for People Who are Sick or Dying,” (Connor
Court
Publishing).
Tonti-Filippini is the Associate Dean and Head of Bioethics at the John
Paul II
Institute for Marriage and Family, in Melbourne, Australia. He was
Australia’s
first hospital ethicist, 28 years ago, at St. Vincent’s Hospital,
Melbourne.
Apart from his professional qualifications, he has first-hand
experience, as
someone who is terminally ill and who for many years has battled a
variety of
chronic health problems. In fact, the book contains a sprinkling of his
own
experiences as a hospital patient and how he lived first-hand the
application,
or lack of, bioethical principles.
In the first chapter of the book Tonti-Filippni discusses a number of
general
matters regarding the relationship between patients and the health care
system.
In one section he deals with the matter of health care principles as
developed
in Catholic tradition.
One of them, stewardship, originated in the Middle Ages and centers on
the idea
that humans are stewards, responsible for the care of their body. This
is
greatly different from a worldview that sees life as expendable if it
loses its
utility. The principle of the inviolability of human life is related to
the
first.
A third principle is that of totality, which sees each part of the body
as
existing for the good of the whole. According to this the lower
functions of
the body are never sacrificed except for the better functioning of the
total
person, and the fundamental faculties that essentially belong to being
human
are never sacrificed, except when necessary to save life.
Extraordinary care
The book’s second chapter deals with the various issues of care for
those who
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
burdensome or
disproportionate to the expected outcome can be discontinued. This is
very
different from suicide, which contradicts the natural inclination to
preserve
our lives.
One topic examined in the chapter is that of resuscitation orders. When
a
person is suffering from a serious disease an attempt to re-start a
person’s
heart if it fails is unlikely to succeed. Attempting to resuscitate
every
person would mean no one could die in peace, Tonti-Filippini explained.
Resuscitation
is also very intrusive and cardiac massage often breaks ribs,
especially in the
elderly.
The author says that among the factors to be taken into account in
deciding
whether or not to issue a “do not resuscitate order” are: the patient’s
state
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
person who
is refusing nutrition and hydration in order to die to change their
minds.
Turning to euthanasia, which is distinct from withholding a futile
treatment,
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
future.
Indeed, Immanuel Kant said that suicide was wrong because it involved
treating
oneself as an object or a means to an end.
Physician-assisted suicide also contradicts the role of a doctor in
seeking to
maintain life and health. If euthanasia were possible the focus would
shift
from palliative care to that of ending people’s live.
Not for nothing, Tonti-Filippini stated, have virtually all national
medical
organizations in the English-speaking world unequivocally rejected the
practice
of euthanasia and physician-assisted suicide as contrary to the ethos
of
medical care.
Respect for life
Responding to the criticism that the sacredness of human life is a
religious
belief that should not be reflected in civil law, Tonti-Filippini
commented
that the inviolability of human life is not only a religious notion,
but is
recognized in international human rights law.
When it comes to people who are in an unresponsive state, the respect
for their
lives remains intact because it is not based on the function they can
or cannot
carry out, but on who they are.
Proponents of euthanasia frequently argue that carefully drawn-up
legislation
will prevent any abuses and will limit the practice to those really in
need.
Tonti-Filippini pointed out that the experience in countries where
euthanasia
is legal demonstrates the contrary. There is indeed a “slippery slope”
and
moreover the will to live is likely to be affected by the option of
euthanasia
as some people will feel they should not be a burden on their families.
In other chapters Tonti-Filippini explores themes such as mental
illness,
suffering as seen from a Christian perspective, and what it means to
live with
chronic illness and pain. Overall, the book manages to combine in a
very
persuasive way ethical norms and Christian principles, illuminated by
the very
poignant personal experiences of the author.
Copyright Notice
(c) Copyright 1999-2024 Allergy Associates of New London, PC