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PubMedDate not supplied

Physician-assisted suicide and euthanasia: German Protestantism, conscience, and the limits of purely ethical reflection.

In this essay I shall describe and analyse the current debate on physician assisted suicide in contemporary German Protestant church and theology. It will be shown that the Protestant (mainly Lutheran) Church in Germany together with her Roman Catholic sister church has a specific and influential position in the public discussion: The two churches counting the majority of the population in Germany among their members tend to "organize" a social and political consensus on end-of-life questions. This cooperation is until now very successful: Speaking with one voice on end-of-life questions, the two churches function as the guardians of a moral consensus which is appreciated even by many non-believers. Behind this joint service to society the lines of the theological debate have to be ree-discovered. First it will be argued that a Protestant reading of the joint memoranda has to be based on the concept of individual conscience. The crucial questions are then: Whose conscience has the authority to decide? and: Can the physician assisted suicide be desired faithfully? Prominent in the current debate are Ulrich Eibach as a strict defender of the sanctity of life, and on the other side Walter Jens and Hans Kung, who argue for a right to physician assisted suicide under extreme conditions. I shall argue that it will be necessary to go beyond this actual controversy to the works of Gerhard Ebeling and Karl Barth for a clear and instructive account of conscience and a theological analysis of the concepts of life and suicide. On the basis of their considerations, a conscience-related approach to physician assisted suicide is developed.

Attitude to Death↗
PubMed1998

Faith and reason and physician-assisted suicide.

Aquinas's conception of the relationship of faith and reason calls into question the arguments and some of the conclusions advanced in contributions to the debate on physician-assisted suicide by David Thomasma and H. Tristram Engelhardt. An understanding of the nature of theology as based on revelation calls into question Thomasma's theological argument in favor of physician-assisted suicide based on the example of Christ and the martyrs. On the other hand, unaided reason calls into question his assumptions about the nature of death as in some cases a good for the human person. Finally, if Aquinas is right about the relationship of faith and reason, Engelhardt's sharp contrast between "Christian" and "secular" approaches to physician-assisted suicide needs reconsideration, although his conclusions about physician-assisted suicide would find support.

Attitude to Death↗
PubMed1999

Blood transfusion and the pregnant Jehovah's witness patient: avoiding a dilemma.

The pregnant Jehovah's Witness patient's refusal of lifesaving transfusion creates a conflict for the physician. While legal steps may be initiated to address the problem, a medical approach stressing prophylaxis which anticipates and avoids the ethical dilemma of managing a hemorrhaging pregnant Jehovah's Witness is preferable.

Blood Transfusion↗
PubMed1993

"Natural family planning": effective birth control supported by the Catholic Church.

During 20-22 September Manchester is to host the 1993 follow up to last year's "earth summit" in Rio de Janeiro. At that summit the threat posed by world overpopulation received considerable attention. Catholicism was perceived as opposed to birth control and therefore as a particular threat. This was based on the notion that the only method of birth control approved by the church--natural family planning--is unreliable, unacceptable, and ineffective. In the 20 years since E L Billings and colleagues first described the cervical mucus symptoms associated with ovulation natural family planning has incorporated these symptoms and advanced considerably. Ultrasonography shows that the symptoms identify ovulation precisely. According to the World Health Organisation, 93% of women everywhere can identify the symptoms, which distinguish adequately between the fertile and infertile phases of the menstrual cycle. Most pregnancies during trials of natural family planning occur after intercourse at times recognised by couples as fertile. Thus pregnancy rates have depended on the motivation of couples. Increasingly studies show that rates equivalent to those with other contraceptive methods are readily achieved in the developed and developing worlds. Indeed, a study of 19,843 poor women in India had a pregnancy rate approaching zero. Natural family planning is cheap, effective, without side effects, and may be particularly acceptable to the efficacious among people in areas of poverty.

Catholicism↗
PubMed1996

Human reproduction: dominion and limits.

The general struggle throughout Christian history has been to seek the proper balance between dominion and limits, intervention and nonintervention, givenness, and creativity. This struggle has worked itself out in six areas that touch human life. In this essay, I will revisit the Catholic tradition's treatment of these in terms of dominion and limits to see whether we can discern developmental patterns that might suggest an approach to issues pertaining to the sources of life (reproductive ethics) as we move into the next century.

Abortion, Induced↗
PubMed1993

Care of the dying: a Catholic perspective. Part III: Clinical context--good palliative care eases the dying process. Catholic Health Association.

In the midst of a push for legalized euthanasia and assisted suicide in the United States, the Catholic healing tradition should provide good palliative care and support for dying patients. Catholic healthcare institutions can have a counterinfluence on the euthanasia movement if they strive to relieve all forms of pain-physical, psychological, social, and spiritual. Care givers must adapt their pain management methods to diverse groups of patients and their needs. Comprehensive pain management includes not only specialized clinical programs to control physical pain, but also counseling and human support to minimize psychological pain, community support groups to counter social pain, and pastoral care resources to address spiritual pain. Truthful communication lies at the heart of the therapeutic relationship. Healthcare institutions can likewise organize themselves internally to offer optimal support programs for those who are dying, their families, and their care givers. Necessary ingredients for a comprehensive approach include integrated treatment plans, hospitable environments, policies on advance directives and collaborative decision making, ethics committees that are well versed in end-of-life issues, education programs, and a hospice philosophy of care.

Advance Directives↗
PubMed1986

Justice, compassion needed in treating AIDS patients.

Caring for patients with AIDS presents an emotional and ethical challenge for care givers. Not only do AIDS patients have great medical needs but they also must cope with the attitudes of a society that has stigmatized them. Stigma complicates the health care decisions that must be made, since many patients with AIDS may not have a supportive family or friends to assist with care. In these situations the health care facility becomes the patient's home and health care workers become the patient's family. Care givers therefore have a unique opportunity to affirm the dignity and goodness of AIDS patients by assuring them confidentiality and treating them with compassion. When decisions about life-sustaining treatments must be made, the care giver's duty is to respect the patient's choice of treatment. Prolonging a patient's dying should not be considered an option if it is done only as a means of healing the family's grief; if patients cannot trust providers to honor their requests to discontinue treatments that become useless or inhumane, they may hesitate to seek helpful treatment. Although a voluntary approach to caring for patients with AIDS may be preferable, employees' resistance to caring for patients usually can be dispelled through education. If a mandatory approach to care is taken, the standards of participation should apply to all--including physicians, administrators, and managers.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

Bioethics and the challenges of the 21st century.

Bioethics is both a field of academic research and practical activity. It is understood as a body of scholarship directed to a better understanding of moral problems associated with health care and the biomedical sciences. As Romanian Orthodox experience the transformation of their culture through importing Western science and technology, they must critically assess the moral presuppositions that come attached to these forces. An authentic Orthodox Christian approach to health care and the biomedical sciences, as well as to bioethics, must develop a critical maturity. The challenge of Orthodox Christians in Romania is to join with Orthodox elsewhere in articulating an authentically Orthodox Christian bioethics.

Bioethics↗
PubMedDate not supplied

Relational responsibility, and not only stewardship, a Roman Catholic view on voluntary euthanasia for dying and non-dying patients.

The Roman Catholic theological approach to euthanasia is radically prohibitive. The main theological argument for this prohibition is the so-called "stewardship argument": Christians cannot escape accounting to God for stewardship of the bodies given them on earth. This contribution presents an alternative approach based on European existentialist and philosophical traditions. The suggestion is that exploring the fullness of our relational responsibility is more apt for a pluralist--and even secular--debate on the legitimacy of euthanasia.

Advisory Committees↗
PubMedDate not supplied

Why physician-assisted suicide perpetuates the idolatory of medicine.

Adequate response to physician-assisted suicide and euthanasia depends on fundamental philosophical and theological issues, including the character of an appropriate philosophically and theologically anchored anthropology, where the central element of traditional Christian anthropology is that humans are created to worship God. As I will argue, Christian morality and moral epistemology must be nested within and understood through this background Christian anthropology. As a result, I will argue that physician-assisted suicide and euthanasia can only be one-sidedly and inadequately appreciated through rational appeal to central values, such as "human dignity" and "self determination", or through "sola scriptura" biblical interpretation, or individual judgments of conscience. Adequately addressing physician-assisted suicide and euthanasia will depend on a more fundamental spiritual-therapeutic approach. This cluster of moral, epistemological, anthropological, and bioethical claims will be explored by drawing on the texts of St. Basil the Great, St. Maximos the Confessor, and St. Isaac the Syrian. Their reflections on medicine, the human good, and its relationship to worship, spiritual therapy, and God will be used as a basis to indicate a broader philosophical perspective, which will be needed to avoid a one-sided, incomplete approach to the challenges of physician-assisted suicide and euthanasia. Medical morality, I argue, is best understood within categories that transcend the right, the good, the just, and the virtuous; namely, the holy.

Bioethics↗
PubMed1997

Prolonging life: an Orthodox Christian perspective.

While Orthodox Christianity does not find explicit statements about the morality of prolonging life in the usual doctrinal sources, the Scriptures and the Fathers of the Church, there are elements in Tradition which bear upon the issue. These include Orthodox spirituality's emphasis on the "wholeness" of the human person, its liturgical and synergistic view of human life, and its understanding of our moral ambiguity as fallen human beings in a fallen world. This last point, in particular, means that we do not usually have a clear choice between right and wrong, and that we cannot always trust ourselves to know which choice is the right, or even the better one. Therefore, we must always approach decisions about death and dying with humility and in a spirit of repentance, aware of the imperfection of all we do and trusting in the mercy of God.

Attitude to Death↗
PubMed1998

Physician-assisted death: doctrinal develoment vs. Christian tradition.

Physician-assisted suicide offers a moral and theological Rorschach test. Foundational commitments regarding morality and theology are disclosed by how the issue is perceived and by what moral problems it is seen to present. One of the cardinal differences disclosed is that between Western and Orthodox Christian approaches to theology in general, and the theology of dying and suicide in particular. Confrontation with the issue of suicide is likely to bring further doctrinal development in many of the Western Christian religions, so as to be able to accept physician-assisted suicide and euthanasia.

Attitude to Death↗
PubMed1997

A United Methodist approach to end-of-life decisions: intentional ambiguity or ambiguous intentions.

The position of the United Methodist Church on end-of-life decisions is best described as intentional ambiguity or ambiguous intentions or both. The paper analyzes the official position of the denomination and then considers the actions of a U.M.C. bishop who served as a foreman for a trial of Dr. Jack Kevorkian. In an effort to find some common ground within an increasingly divided denomination, the work concludes with a consideration of the work of John Wesley and his approach to human death.

Advance Directives↗
PubMed1983

Modern psychotherapy and Halakhic values: an approach toward consensus in values and practice.

In this paper, I have examined in some detail a number of examples of actual and potential consensus between Jewish ethics and the practice of modern psychotherapy, psychology, and psychiatry. Moreover, I have posited specific halakhic models which represent analogies to modern psychotherapeutic principles and practices, which through analogy lend specific halakhic guidelines to modern practice. The unitary halakhic approach presented here is thus both heuristic--in that it seeks to demonstrate the ways in which psychotherapeutic processes are essentially halakhic ones--as well as practical. Through this approach, psychological theory and practice have been brought into intimate contact with the ethical requirements of the halakhically committed mental health practitioner and his or her patient, filling an inexcusable void in halakhic application to modern technology, and setting a direction for future work in this area.

Ethics, Medical↗