Saturday, 8 August 2009

Matters of Life & Death

The case of Christian Rossiter

A significant legal judgement is about to be made in the Supreme Court in Perth (Australia) to determine whether a nursing home should be allowed to stop feeding a quadriplegic man. This tragic story had its beginning when a perfectly healthy 49 year old man, Christian Rossiter, was hit by a car and developed spastic quadriplegia. He is now fed through a tube in his stomach and wants to end his life. He has asked for the nursing home to stop feeding him. He says he is in a living hell with no control over his body. In making a testimony to the court he stated:

"I'm Christian Rossiter and I'd like to die. I am a prisoner in my own body. I can't move. I can't even wipe the tears from my eyes."

The staff in the nursing home are in effect asking, at Mr Rossiter's request, to be allowed to kill him, not just let him die. This is because the Criminal Code in Australia makes it clear that if there is somebody in your care and they can't remove themselves from this care, that you are obliged to provide them with what is necessary to sustain life. This is a very sad and tragic story, and no doubt many people will want to say, let this man have his wishes granted, but there are tremendous legal and ethical consequences that will flow from such a decision. I will allow the lawyers to deal with the legal issues, but every person has a responsibility to consider the ethical issues that the request from these nursing staff raises.

'Matters of Life and Death' by John Wyatt

Professor John Wyatt has written a helpful book that addresses this particular type of ethical issue. The book called 'Matters of Life and Death' has been around since 1998, but there are few publications that are as good. The strength of the publication is that it has been written by paediatrician who, like all medical practitioners, has been faced with decisions that have consequences for the life or death of patients. He writes as a Christian who tries to apply his faith and the Bible to the ethical dilemmas that he and other medical practitioners face every day. He challenges all of us (not just medical practitioners), to think about these issues. He addresses the very issues raised for Mr Rossiter's carers in his chapter on euthanasia and assisted suicide and suggests that:

‘Death like the sun, should not be stared at.’ So said the French philosopher…Yet advances in medicine force us to do just that. Of course, all generations have discovered that they cannot evade the reality of death. But if we are going to develop an authentic Christian response to the issues of euthanasia and medically assisted suicide, we need to stare at death with renewed intensity. We need to stare at its mystery and awful finality, at the questions and fears that it raises, and at our own mortality….death and dying are not just ‘out there’ as abstract theoretical issues. Death is in our midst.’ (p.169)

New College has invited Professor Wyatt to present its 2009 annual lecture series that we have titled 'Bioethics and future hope'. This series of three public lectures will be presented on the UNSW campus from the 8th to 10th September. They will address the ethical dilemmas faced by our times and offer biblical insights into how we might cope much better with these and make right choices.


He offers this challenge as an introduction to the series:
"Our understanding of the future changes the way we think about our ethical responsibilities in the present. The secular perspective derived from the Enlightenment sees the future as a human construct, an artefact created by human ingenuity. In contrast, the neoplatonic future offers the hope of an escape from the material world into the timeless realm of the spirit. The biblical view of the future provides a third radical perspective. The future is not a human artefact; it is a reflection of the loving purposes of God. Yet the physical nature of our humanity is not obliterated, it is affirmed and vindicated. For Christians, future hope lies not in being released from our physical bodies, but in becoming the people we were meant to be.”
There will be MP3 recordings made available after the lectures on the New College Website. The details for those able to attend the lectures follows.

Details on the 2009 New College Lectures


Dr John Wyatt is Professor of Ethics & Perinatology at UCL. He has a clinical background as an academic neonatologist working on the mechanisms, consequences and prevention of brain injury in critically ill newborn infants. His work is now concentrated on ethical issues raised by advances in reproductive and medical technology at the beginning of life, research ethics and governance and the philosophical basis of medical practice.

Lecture 1 - Bioethics and creation
(Tuesday 8th September, 7.15pm)

How do different conceptions of the origins of the cosmos impact on current bioethical debates? What does creation order imply about reproductive technology, parenthood, and the intrinsic value of human life?

Lecture 2 - Bioethics and redemption (
Wednesday 9th September, 7.30pm)

The minimization of suffering is central to the moral vision of utilitarianism. How does the Easter story transform perceptions of suffering and how does this impact on current bioethical controversies about assisted suicide, euthanasia, ageing and degenerative diseases?

Lecture 3 - Bioethics and future hope (
Thursday 10th September, 7.30pm)

The Enlightenment project aims to create better humans by the use of technology. How should be respond? What are the implications of the Christian hope for bioethics? How should we treat our patients now in the light of the future?

PLEASE NOTE - RSVP is essential for all lectures by Friday 4 September 2009. Full details, venues and directions can be found HERE.

Related links


ABC News Story 'End my living hell' (
here)

Related
CASE blog posts on medical ethics (here)

Link to Case magazine issue on 'Living and dying ethically' (here)

Link to 2009 New College Lecture information (
here)

* Photo of Christian Rossiter, ABC News

9 comments:

Anna M Blanch said...

Looks like a great series of lectures coming up from John Wyatt!

Trevor Cairney said...

Hi Anna, it's a shame that you won't be here. Hope things are going well in the Texas. Regards, Trevor

Timaahy said...

Trevor,

I've always found the Christian position on euthanasia a little confusing... perhaps you can help me out.

If Christianity is true, Jesus came to earth not just knowing He was going to be put to death, but actually wanting to be put to death. How is this not suicide?

No, He didn't technically kill Himself, but He wanted to die, and He put himself into a position that would allow it to happen.

So I have three questions, which I hope you might be able to answer.

1. How do you reconile Jesus' actions with a moral objection to euthanasia?

2. If Jesus never sinned, how is it morally wrong to place yourself in a position where you know you are going to die, if you believe some good will come of it?

3. Would a believing Christian have had a moral obligation to do everything in their power to stop Jesus from being put to death?

Tim

Trevor Cairney said...

Hi Tim,

Nice to hear from you again. Thanks for your questions. I think the confusion you speak of is caused by three things. First, you overlook the fact that Christians believe that God is the one who creates life and therefore is the only one who has authority over death. The Bible teaches (1 Cor 2:19-20) that our lives are not our own: “..do you not know that your body is a temple of the Holy Spirit within you, whom you have from God? You are not your own, for you were bought with a price. So glorify God in your body.” Jesus reminded his disciples through the parable of the ‘Rich Young Fool’ (Luke 12:13-21) that it is God who determines when life ends. While you might not accept this, that's what the Bible teaches and that's what Christians believe.

Second, you overlook the Bible's teaching that Jesus came as the Son of God to sacrifice his life for a humanity alienated from him due to their sin and rebellion. In giving his life for others he was not committing suicide, any more (say) than a father who jumps into a massive surf to save his 12 year-old son. The father gives his life for his son, Jesus does it for humanity.

Third, we are talking about euthanasia not suicide. The tragic example of Christian Rossiter is a case that will require people to withdraw support necessary for life that will lead to death. This is a huge ethical question. I'd be intrigued to know how you would decide when an act that involves withdrawing that which sustains life for others is acceptable and when it's not. From my perspective, your first two questions don't require an answer because you draw a false parallel between Jesus sacrificing his life in love for the world with suicide and euthanasia.

Your third question is an interesting question that I can't say I've thought about before (thanks for asking it). The question can only be hypothetical because you ask it with knowledge of the outcome of Jesus' sacrifice (at least you know what Christian's believe happened). Jesus as man knew that he would experience the cross like other men. But Jesus as God's son knew that he must die as a sacrifice for the lost. That's why Jesus prayed on the Mount of Olives:

"Father, if you are willing, remove this cup from me. Nevertheless, not my will, but yours, be done."

Should Christians oppose an unjust death? Yes. But Jesus’ death was in accordance with God's plan for his own people. Jesus as God chooses to give his life as a ransom for us – this is the most perfect of sacrifices (not suicide). Should Jesus' disciples have ignored Jesus’ own commands and teaching about the necessity of his death? A death I might add that is at the hands of sinful men. Jesus' sacrifice was of necessity a consequence of man's rebellion against their creator. Should Jesus followers have tried to stop Jesus’ march to the cross? He suggested otherwise, for it was God's purpose that Jesus should die at the hands of evil men. Your third question seems strangely trivial to me in the light of the words he spoke as recorded in Luke 18:31-34:

And taking the twelve, he said to them, "See, we are going up to Jerusalem, and everything that is written about the Son of Man by the prophets will be accomplished. For he will be delivered over to the Gentiles and will be mocked and shamefully treated and spit upon. And after flogging him, they will kill him, and on the third day he will rise."

But they understood little of what he said. This saying was hidden from them, and they did not grasp what was said.

As it turns out the disciples largely run away in fear for they still did not grasp the enormity of that which they had witnessed. But that was to change with Jesus resurrection, for sin and death had been defeated and God’s plan of redemption had revealed fully.

Thanks for your comment.
Regards, Trevor

Timaahy said...

Hi Trevor,

Thanks for responding.

Firstly I guess I should tell you that I went to Catholic schools all my life. Up until year 9 I went to a school run by Opus Dei (who, as you probably know, are what you might call “hard-core Catholics”), and from year 10 on I went to a Jesuit school. So I am well versed in Christian beliefs, albeit from a Catholic perspective. I am, however, no longer a believer, as I’m sure you’ve guessed.

You said that I overlooked the fact that God is the only one who determines when life ends. If this was true, isn’t there an argument for doctors not performing life saving operations? (Indeed, some Christians do believe this and refuse all medical treatment.) Isn’t there an argument for, in your example, a father not jumping into the surf to save his son, because it’s God’s will that the son should die? But then you might say, “It’s God will that the father tries to save his son”. But how do you know what God’s will is? Could it not be God’s will to have someone remove a terminally ill patient’s feeding tube?

Your second point also raises more issues. Presumably the father in your example intended to save his own life as well as his son’s. This is, of course, not suicide. Suicide is the intentional taking of one’s own life. I think the key point is intent, not method. The father jumping into the surf surely wasn’t intending to kill himself, so if he happened to die while saving his son you could hardly call it suicide. Jesus intended to die, and placed himself in a position to allow it to happen, so I think you have to call it suicide, irrespective of who actually nailed him to the cross.

A more fitting parallel to Jesus (as opposed to the father and the drowning son) might be Maximilian Kolbe, someone who deliberately gave his life to save another. Again, it’s still suicide, even if it was a Nazi guard who killed him, and the outcome was noble. He intended to die, and acted in a way to make it happen. To say it’s not suicide would be the same as saying that someone who lay on the tracks was murdered by the train.

And so, in the case of Christian Rossiter, I think that suicide and euthanasia are, for all intents and purposes, the same. He has asked for his life support to be removed. He is unable to do it himself, but he would if he could.

So I don’t think it’s a false parallel at all. The angle I was coming from was that, if (a) you can say that Jesus committed suicide, or at the very least “allowed himself to die”, via the actions of others because (b) he believed it would have some benefit, and (c) Jesus never sinned, then you can only conclude that it is not wrong for someone to end Christian Rossiter’s suffering by withdrawing life support. No one would say that Maximilian Kolbe sinned by giving up his own life (even though, as you said, only God can decide when life ends), and I think it should be obvious that you can make the same argument for Mr Rossiter.

(continued below)

Timaahy said...

(continued from above)

There will be smarter people than me that are better equipped to decide “when an act that involves withdrawing that which sustains life for others is acceptable and when it's not”. There are obviously ethical issues to work through, but I have no problem with the concept itself. At a pinch I would say that if someone of sound mind, in immense pain and low quality of life, with no chance of being cured freely expressed a desire to end their life, we should certainly not stop them. Of course there are issues with the definition of “sound mind” (you might argue, for example, that someone who wants to end their life can’t possibly be of sound mind), and what to do if a patient is simply unable to express their wishes, but, as I said, I have no problem with the concept itself.

Hopefully you now see that my third question isn’t as “strangely trivial” as you first thought. If it would have been wrong for the twelve apostles to prevent Jesus from walking freely into death “at the hands of sinful men”, is it not also wrong for us to prevent Mr Rossiter from freely choosing death? If Mr Rossiter had his life support switched off, both he and Jesus would have freely chosen death at the hands of others, while believing a positive outcome would result. How are these two situations not the same?

Whether or not Jesus had a choice in the matter raises a multitude of other issues. Assuming Christianity is true… On the one hand, he was man, so he had free will. On the other, God sent him to earth so he would die, and he was God anyway, and it was foretold by the Prophets, so it would seem like he didn’t really have a choice at all. If the former, it’s suicide; if the latter, it’s not a sacrifice because he had no choice.

It’s all a little confusing.

Trevor Cairney said...

Hi Tim,

Thanks for another interesting comment, I appreciate your honesty and the way you have presented your arguments. I’ll try to offer a comment on most of your questions by quoting from your comments.

Comment 1 – “God is the only one who determines when life ends. If this was true, isn’t there an argument for doctors not performing life saving operations?”

I don’t think it follows. God determines when life ends, our responsibility is to live life in order to honour him. Valuing, loving and serving others is required of us. Sustaining the life of others is part of our responsibility. As to your question about God's will, I accept your point that we cannot know for sure what God's will is, but we do know that God uses the good, wrong and evil actions of men for his purposes. And yes (as you say) Romans 8 does teach that "all things work together for good, for those who are called according to the will of God".

Comment 2 - "Jesus intended to die, and placed himself in a position to allow it to happen, so I think you have to call it suicide, irrespective of who actually nailed him to the cross."

Jesus is God. He was there at the beginning. Colossians 1:15-20 teaches that "For by him all things were created". While it was the will of the Father that he should die, Jesus chose to give his life as a sacrifice (it was not suicide). No-one who deliberately chooses to die to save the lives of others can be said to be committing suicide.

I think you are right about my example, I could have thought of a better one; as you point out, Jesus act was deliberate, he knew he was going to die to save others. But I think your argument breaks down here, Jesus sacrificed his life as one with authority over life and death. He is uniquely placed to make such a decision as God and man. As an aside, I don't follow your arguments completely about suicide and think that many would question your definition.

Comment 3 (Christian Rossiter) - please note that at no stage have I said whether he should or shouldn't be allowed to stop eating. For me the greatest problem in this sad case is that others have now been give court approval to withdraw care necessary to sustain life. They are being given court approval to end someone's life. The trickiest part about this judgement is that it opens the way for others to similarly withdraw care from someone neecessary for their life to be sustained. I'm not convinced that courts, let alone medical practitioners, family carers or guardians will be able to make such decisions. In this case the person may well be of sound mind (experts need to judge that).

You suggest that "At a pinch I would say that if someone of sound mind, in immense pain and low quality of life, with no chance of being cured freely expressed a desire to end their life, we should certainly not stop them." Many would agree with you, I don't. I think we must strive to help sustain life and improve the quality of life of all who suffer trauma like Mr Rossiter's. But the most significant weakness of the application of your principle is that Christian Rossiter isn't doing it, his carers are.

Your last paragraph about Jesus and his sacrifice is fair comment. I grant that it is difficult to get one's head around. Jesus as God and man was both sent by God to die for the redemption of mankind, but at the same chose to obey the Father.

I accept that if you aren't a Christian and don't accept the infallibility of the Bible that these arguments will be difficult to accept, but I'd point out that many non-Christians will struggle with the recent judgement in Western Australia on ethical, moral and legal grounds alone. This is a very dangerous judgement for them to make.

Nice to hear from you, I've enjoyed the discussion.

Regards, Trevor

Timaahy said...

Thanks Trevor, I have also enjoyed the discussion, and I hope you don't mind me posting these comments.

Tim

Trevor Cairney said...

Thanks Tim, I enjoyed the dialogue. Come to the the New College Lectures to hear John Wyatt talk on the topic. Trevor