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PubMed1995

Suffering, sovereignty, and the purposes of God: Christian convictions and medical killing.

Despite a variety of "non-ecumenical" features in Christian arguments about suicide, assisted suicide, and euthanasia, there are obvious "ecumenical" aspects to be found in the general Christian prohibition of these practices. A fair reading of the Christian tradition requires that we acknowledge both the differences that distinguish particular perspectives and the fundamental themes that allow an identifiably Christian position to emerge in stark contrast to the secular discussion of these issues. Central to Christian interpretations of dying and death are an acknowledgment of God's sovereignty over human life, an understanding of suffering that stresses identification with Christ as the source of Christian hope, and the recognition that God's creative and redemptive purposes are generally (or always) at odds with the deliberate choice of assisted suicide or euthanasia.

Attitude to Death↗
PubMed1995

Observations on the rejection of physician-assisted suicide: a Roman Catholic perspective.

Roman Catholic moral theology follows a centuries-old tradition of moral reflection. Contemporary Roman Catholic moral theory applies these traditional arguments to the realm of medical ethics, including the issues of active euthanasia and physician-assisted suicide. Unavoidable moral limits on licit medical intervention sometimes require that the moral duty to treat cede to the duty to cease treatment when measures become more harmful than beneficial to the patient. This does not reduce the need for the compassionate use of palliative care in response to suffering. However, it does mean that rather than being excessively committed to maintaining mere biological human life, or actively seeking death, that we learn a sober realism about the limits of human life. Catholic moral analysis examines an act objectively, both in its relation to the agent and as a material event in the world. This allows both the virtuous or vicious intentions of the agent and the effects of the action to be included in its moral evaluation. Thus, Catholic moral analysis is both quasi-deontological and quasi-consequentialist. Objectively, active euthanasia and physician-assisted suicide, as acts of deliberate killing, are seen as repugnant, in that they fail to incarnate a benign inner intention or to form an agent in virtue. Catholic moral theology is extremely skeptical that an act of intending death directly can be consonant with a sincere compassion for the dying, suffering person and views it as a direct negation of the precious gift of human life.

Analgesia↗
PubMed1995

Suffering and the sovereignty of God: one Evangelical's perspective on doctor-assisted suicide.

This paper presents my personal convictions, as an Evangelical, regarding the absolute impropriety of doctor-assisted suicide for Christians. They have been "bought with a price" and are owned by Another. Hence, they must always strive to glorify God in their bodies, both in life and in death. Although they crave the well-being of temporal health, when they are ill seek healing or relief, and may well recoil even from the thought of suffering and dying, they should realize that their values and priorities must be rooted in biblical truths and that their well-being is eternal and not temporal, spiritual and not material. As Christians, their attitudes and responses to suffering and dying must be molded by the reality that their Creator and Sovereign will cause all things to work together for their good and that their Lord has called them into a fellowship of His suffering in which they are sustained by dependence upon Him. Hence, for Christians to take their lives in order to escape from the trials and testings ordained by Him would be a failure of love and a breach of trust.

Attitude to Death↗
PubMed1995

The act of death and the gift of suffering: a response to Breck, Amundsen, and Bresnahan.

This response to the articles by Breck, Amundsen, and Bresnahan is argued from a traditional Orthodox point of view, which accepts the historical Tradition of the Church and recognizes the relevance of this Tradition in the modern world. Traditional Orthodox ethics is grounded in a radical perception of the Resurrection of Christ. Many Western and Eastern commentators on Orthodox religion and spirituality have noted the centrality of the Resurrection to all facets of our Tradition. Thus the discussion of euthanasia should be seen in the light of the Resurrection of Christ.

Attitude to Death↗
PubMed1996

What shall we do with Norman? An experiment in communal discernment.

We were a group of Christian friends searching for affirmations that lay at the heart of our faith and reached to the limits of our existence and moral authority. As we have reflected on our role in deciding whether and to what extent we could assist in allowing our terminally ill friend, seventy-nine-year-old, Norman to die, we were deeply troubled by the moral ambiguity of our involvement. Through a careful process of authority through communal discernment, our responsibility for Norman became clear: we were to assist him in living the life he embraced in baptism -- a life which included a destiny that was conformed to the crucified and risen one. That was not the destiny we chose for Norman; it was the destiny he owned. We recognized with Norman that our lives are not our own to be guided by autonomy and liberty, but rather to be lived for the glory of Jesus the Christ.

Aged↗
PubMed1996

Health, fortune, and moral authority in medicine.

The Christian conviction about Divine Providence encourages a novel account of the moral content of health and authority in the health care context. While health can be understood as the disposition of a living body to be able to proceed in the world well, as a species of freedom it is informed by the particular projects and concerns that Christians hold deepest. This is due to the fact that health acquires content, and thus becomes desirable as a particular type of good, only in relation to judgments about the good life. Aquinas' reflections concerning the good of health and its partial slavery to fortune reveal a Christian past that dwelt on the intrinsic and instrumental good of health. A rich Christian tradition in which health as intrinsically good, a good of the body, is ordained to the interests of right Christian virtue. Each of these factors affects the character of the health to be pursued and the authority of the physician as determining the ends and means of medicine.

Christianity↗
PubMed1996

Biblical authority and the not-so strange silence of Scripture about abortion.

Biblical authority is definitive for many Protestants in matters of faith and practice. The question this essay addresses is the deafening silence of this Scriptural authority on the controversial issue of abortion, especially because Christian scholars have argued vehemently against this practice. In particular, Michael Gorman's recent article 'Why is the New Testament silent about abortion?' raises many substantive issues with implications for the very meaning of authority, faith, and the life of the community. It is contended that elective abortion poses significant substantive issues with which a woman, or couple, must struggle, and that it is inappropriate (perhaps unfaithful) to make such a profound decision according to unfeeling or out-modeled patriarchal rules.

Abortion, Induced↗
PubMed1996

Scripture, history, and authority in a Christian view of abortion: a response to Paul Simmons.

In this reply to Paul Simmons, it is argued that while biblical scripture should be understood as the Christian's first and final authority, it is appropriate to draw on other writings as sources for moral reflection. Responsible biblical interpretation and theological reflection must include careful historical analysis. It is inaccurate and anachronistic to read into early Jewish and Christian thinkers a position much like the reigning secular philosophical-legal position on abortion, where fetal non-personhood and individual freedom results in abortion without legal constraints. Careful scholarship reveals that a theological community-based Christian ethic, which develops from first century reflections and biblical canonical authority, prohibits direct abortion as an option for the Christian community.

Abortion, Induced↗
PubMed1996

Suffering, meaning, and bioethics.

Suffering evokes moral and metaphysical reflection, the bioethics of suffering concerns the proper ethos of living with suffering. Because empirical and philosophical explorations of suffering are imprisoned in the world of immanent experience, they cannot reach to a transcendent meaning. Even if religious and other narratives concerning the meaning of suffering have no transcendent import, they can have aesthetic and moral significance. This understanding of narratives of suffering and of their custodians has substantial ecumenical implications: chaplains can function as general custodians of narratives and sustainers of a generic religious meaning. This understanding is contrary to traditional Christianity, which discloses a transcendent significance of human suffering found in a very particular history involving particular persons: Christ as the second Adam through the submission of the second Eve has taken on our nature so that we can be united with God. Human suffering is tied to human sin, not simply as a punishment for sin, much less as an opportunity to discharge a supposed temporal punishment due to sin. Human suffering is the result of our rebellious free choices. It provides an opportunity for humility and submission, so that, united to the cross of Christ, sin can be forgiven and suffering set aside in the Resurrection. Knowledge of this framing context for all human suffering is accessible not through rational argument. It is a knowledge garnered through repentance, purification of the heart, illumination by God's grace, and unification with God. Christian bioethics is embedded in the narrative of suffering, which is part of the history of salvation and which encompasses and places all of medicine in its terms.

Bioethics↗
PubMed1996

Clinical ethics and the suffering Christian.

Contrary to the ecumenical spirit of our time, the differences among the Christian religions bring into question what one can say or do in common with fellow Christians. This issue, echoing the program of this journal, accentuates those differences, specifically when we focus on the Christian who is ill and suffering. At the bedside, it is the specifics of a religion, including not only its doctrines, but its informing and sustaining narratives, that must particularly be brought into play for the sake of the patient. Given this, our focus in this article regards what such a view implies for the clinician who is caring for a Christian patient whose religion he may or may not share, in general or in its specifics. Our basic conclusion is that the tendency for the clinician to act as both the patient's spiritual counselor, as well as his clinician, is generally neither prudent nor appropriate. Both hats should not be worn concurrently. This view is advanced not only because of concerns regarding patient vulnerability and the possible abuse of power, but also because the two roles may collide with or undermine each other.

Christianity↗
PubMed1996

Equal access to health care: a Lutheran lay person's expanded footnote.

Can proposing a policy of equal access to health care be justified on Christian grounds? The notion of a "Christian justification" with regard to Christians' political activity is explored in relation to the New Testament texts. The less demanding policy of granting "rights to (basic) health care," the meaning of Jesus' healing activities, early Christian welfare schemes, and Christian grounds for the ascription of "rights" are each discussed. As a result, with some stretching of the neighbor-love and missionary imperatives it is proposed that a basic health care policy can be legitimized. With regard to equal access to health care, however, all attempts to derive an equalizing imperative from the spiritual "equality among humans" or by way of the "love your neighbor as yourself" imperative are shown to fail. Particular attention is given to whether "attending to the least of my brothers' needs" obliges Christians to satisfy those needs optimally, as well as to the personal involvement aspect of the love-commandment in its simultaneously spiritual and temporal orientations.

Christianity↗
PubMed1996

Equality in health care: Christian engagement with a secular obsession.

A frenetic search for equality lies at the center of much secular and even "Christian" bioethics. In a secular world, if one does not believe in God, if this life is one's whole existence, it would seem that one could not settle for less than equal approbation, especially equality before the risks of suffering and death, which medicine promises to ameliorate. Yet, the concern for equality in health care is puzzling. After a modest level of access to health care there is little difference in average life expectancy. Are concerns for equality in health care even vaguely Christian? The pursuit of Christian perfection has never been correctly equated with state-imposed egalitarianism. Furthermore, an all-encompassing, secular, egalitarian health care system may provide equal access to significantly immoral medical treatments. In contrast to secular thought, the call of Christianity is a call to holiness, not a call to an egalitarianism that superficially resonates with certain elements of Christian thought.

Christianity↗
PubMed1997

Spirituality in nursing theory and practice: dilemmas for Christian bioethics.

Moral strangerhood is due in part to competing worldviews. The profession of nursing is experiencing a paradigm shift which creates ethical dilemmas for both Christian nurses and Christian patients. Nursing's new focus on spirituality and spiritual care presents itself as broadly defining a desired state or patient outcome -- spiritual integrity -- supposed to be applicable to all patients of all faiths. Analysis of nursing's definition of spirituality reveals assumptions and values consistent with an Eastern/New Age worldview which may cause hostility towards Christian patients stereotyped as dogmatic or noncompliant.

Christianity↗
PubMed1997

Holiness, virtue, and social justice: contrasting understandings of the moral life.

Being a Christian involves metaphysical, epistemological, and social commitments that set Christians at variance with the dominant secular culture. Because Christianity is not syncretical, but proclaims the unique truth of its revelations, Christians will inevitably be placed in some degree of conflict with secular health care institutions. Because being Christian involves a life of holiness, not merely living justly or morally, Christians will also be in conflict with the ethos of many contemporary Christian health care institutions which have abandoned a commitment to Christian spirituality. In this regard, managed care raises the special question of how Christian institutions can act morally under financial constraints and maintain their character while under the control of secular managers. This question itself raises the further question as to why health care institutions need even pose this query when there are Christian physicians and nurses who could work for less, or Christian men and women who could become sisters and brothers and work for nothing. Contemporary challenges to Christians to maintain their integrity in a post-Christian world have much of their force because Christians have failed to maintain traditional Christian sprituality. In the face of that failure, Christian physicans and nurses will find themselves in greater conflict with health care institutions, because few will any longer understand the requirements of traditional Christianity. In its place, they will have put a generic spirituality, a value-neutral understanding of the role of the health professional, and an anonymous commitment to social justice.

Abortion, Induced↗
PubMed1997

The Christian physician in the non-Christian institution: objections of conscience and physician value neutrality.

Christian physicians are in danger of losing the right of conscientious objection in situations they deem immoral. The erosion of this right is bolstered by the doctrine of "physician value neutrality" (PVN) which may be an impetus for the push to require physicians to refer for procedures they find immoral. It is only a small step from referral to compelling performance of these same procedures. If no one particular value is more morally correct than any other (a foundational PVN premise) and a physician ought to be value neutral, than conscientious objection to morally objectionable actions becomes a thing of the past. However, the argument for PVN fails. Therefore, Christian physicians should state their values openly, which would allow patients the ability to choose like-minded physicians. Some possible responses to this erosion of conscientious objection include, disengagement from non-Christian institutions, the formation of distinctly Christian medical institutions and political action. However, for the Christian the initial focus should be on a life of holiness which requires each of us to avoid evil.

Abortion, Induced↗
PubMed1997

Ethical issues in managed care: a Catholic Christian perspective.

A Christian analysis of the moral conflicts that exist among physicians and health care institutions requires a detailed treatment of the ethical issues in managed care. To be viable, managed care, as with any system of health care, must be economically sound and morally defensible. While managed care is per se a morally neutral concept, as it is currently practiced in the United States, it is morally dubious at best, and in many instances is antithetical to a Catholic Christian ethics of health care. The moral status of any system of managed care ought to be judged with respect to its congruence with Gospel teachings about the care of the sick, Papal Encyclicals, and the documents of the Second Vatican Council. In this essay, I look at the important conceptual or definitional issues of managed care, assess these concerns over against the source and content of a Catholic ethic of health care, and outline the necessary moral requirements of any licit system of health care.

Administrative Personnel↗
PubMed1997

In the world but not of it: managing the conflict between Christian and institution.

Christian physicians, nurses and other health care workers must manage a daily conflict of conscience between their Christian faith and predominantly secular health care institutions. This essay examines various efforts for managing these conflicts: a turn towards social justice or a seeking of holiness. Seeking social justice, however, is theologically empty. Traditionally, the Christian requirement that we be "in this world but not of it" requires a journey along a narrow path to holiness. Christian medical morality must, therefore, be understood within this light. However, just as there cannot be generic health care, but rather health care for a particular person's needs and problems there cannot be generic holiness, but only a holiness grounded in worshiping God rightly. In so worshiping the Christian will be assisted in negotiating the inescapable and perilous vocation of being in the world but not of it.

Catholicism↗