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THEO 303 (Su '15) T12 - End of Life Ethical Issues

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by

Hartmut Scherer

on 7 June 2015

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Transcript of THEO 303 (Su '15) T12 - End of Life Ethical Issues

Sources and Image Credit
Adapted resources for this presentation from “A Christian Response to "End-of-Life" Decisions”; accessed June 4, 2015; http://www.apologeticspress.org/apcontent.aspx?category=7&article=58 and Feinberg and Feinberg,
Ethics for a Brave New World
, 253ff and Leon R. Kass, “Beyond Therapy: Biotechnology and the Pursuit of Human Improvement”; accessed June 1, 2015; https://bioethicsarchive.georgetown.edu/pcbe/background/kasspaper.html.
1)
End of Life Ethical Issues
1)
Conclusion
- what is legal may not be what is right in the eyes
of God
A Christian response
- life is complex
- beginning and end of life relate to each other
Two views of human life
Christian view
- created in the image of God (will
exist forever)
Secular view
- temporary; penultimate good
- does not cling to life
- life is sacred (gift of God)
- personhood begins with conception
and ends with death
- kind of highest animal; (facing
extinction)
- supreme or ultimate value
- clings to life because that's all
he/she has
Clarification of terminology
Coma
"a state of profound unconsciousness from which one cannot be roused"
2
Stedman's Medical Dictionary, McDonough in 1994, p. 210.
2)
(Persistent)
Vegetative State
show no behavioral evidence of awareness of self or environment
Brain death
entire brain including the brain stem is irreversibly damaged
"Locked-In" Syndrome
almost completely paralyzed but aware of surroundings
Advance Directive
- appoint health care agent (part 1)
Artificial feeding
- tube feeding through the nose (NG tube)
- what care they want to receive (part 2)
- gastrostomy tube (G-tube; PEG tube)
- inserted through the abdominal wall into
the small intestine (jejunal tube)
Glasgow Coma Scale
assesses degree of brain impairment
Decision-making process
- law of cause and effect
1) eye opening
2) verbal responses
3) motor response (movement)
3 determinants
Is the person going to die as an effect of some disease or injury?
Or is their death caused by some effect (or decision) a family member makes?
We must make sure that our decisions do not become the actual cause of their deaths.
physicians made the majority of decisions regarding particular treatments
1960s
with the emergence of the legal doctrine of "informed consent," the concept of patient autonomy took over
physician
patient
decision-making
Advance directive or living will
- legal instructions regarding your preferences for
medical care if you are unable to make decisions
for yourself
living will
advance directive
- for persistent
vegetative state
- all of living will plus
"end-stage condition"
- life sustaining procedures
for terminal condition
- more options: naming
of health care agent
A closer look at the vegetative state
"Mom, I love you" (after ~17 months)
- returned home 5.2 years after the injury
- diagnosis of the permanent vegetative state
cannot be absolutely certain
- viewed as "vegetables" (subhuman)
- never going to recover to live any type of
"useful" life (problem with the name PVS)
Artificial feeding and hydration
- Nancy Cruzan's car accident
- living being (body/spirit
entity; Gen 2:7)
- never regained consciousness
- court allowed parents to remove the tubes
- termination of ventilation, hydration, artificial
nutrition, and other forms of medical treatment is
legally and medically acceptable
- air, food, and water represent necessary
requirements for any living individual
- without food and water individuals will die from
dehydration within 14 days, not from the disease
or injury
- Christians should not prematurely terminate the
life of someone in a PVS
- Christians must ensure the sanctity of life
- comfort the afflicted loved one through this
traumatic period
- prayerfully seek God's wisdom (James 1:5)
Full transcript