Loma Linda, California, United States …. [Mark A. Kellner/ANN]
Ethical issues surrounding such end-of-life decisions as “physician-assisted suicide,” recently upheld in the state of Oregon by the United States Supreme Court, can be perplexing for Seventh-day Adventist church members and physicians, but also reveal core values, a bio-ethicist at Loma Linda University and its Medical Center said.
“It’s a broad social issue and we have to weigh in. But our effort as people of faith is to weigh in a way that’s consistent with [what] we believe God’s leading to be. Sometimes that puts us in a difficult position,” said Mark Carr, an assistant professor of religion at LLU, who also is director of the Center for Christian Bioethics.
Carr said it was important to differentiate between suicide, euthanasia and palliative care, the latter often found in hospitals and hospices.
“All forms of suicide are fundamentally different in that suicide is an act one engages in upon one’s self,” Carr told ANN in an interview.
“In all forms of euthanasia, someone else is acting upon the patient,” he added. “Generally, in bioethics, you find pretty hard and fast distinctions between all forms of euthanasia, and all forms of suicide.”
The issue of so-called physician-assisted suicide may be a growing one for medical professionals in the future. Noting that seven states in the United States are engaged in discussing legislation on physician-assisted suicide, Carr said the issue isn’t going away any time soon: “We’re not going to avoid this issue; it’s going to be with us for a long time.”
Loma Linda University, a premiere Adventist medical training center with a global reputation for innovative surgeries that enhance the chance for life, has also been contemplating end-of-life issues. On Mar. 2, Dr. Ben Carson, a physician and surgeon renowned for his work in pediatric neurosurgery, will deliver a lecture on the subject as part of the school’s Jack Provonsha Lecture Series, a 10-week series sponsored by the Center for Christian Bioethics. The Provonsha lectures have this year featured a diverse range of perspectives on end-of-life issues from Christian and Jewish speakers.
Palliative care, aimed at easing discomfort and pain, is different, Carr said.
“Palliative care is a different context altogether in that in palliative care, the health care team has decided with the family, with the patient, that it doesn’t make sense any longer to fight the disease. It doesn’t make sense any longer to have aggressive treatments, to reverse things. Its futile, it’s not going to reverse,” he explained.
While many would feel comfortable with the use of palliative care, asking a physician to assist in a suicide by providing enough prescription drugs for the patient to use would pose ethical issues for Adventist health professionals.
“Physicians want to model the compassion of Jesus Christ. They want to do the best they can to extend Christ’s healing ministry,” Carr explained. “And to come to the end of life, and to work with the patient who has said, ‘I know you may not agree with me, but I want to use this law and I want to be able to have that control, and I’ve wrestled with my sense of God’s leading here and the family is agreed with me — they do feel as though God is open to it,’ it’s very difficult for an Adventist physician concerned with these things to come in and say, ‘You know what? I’ve worked with you for 25, 30 years. I just can’t go with you through these last steps.'”
Carr said that if both sides understand each other, such an impasse could be accepted.
“But that’s a struggle for the physician, and I hope you can sense that it’s going to continue to be a struggle,” Carr said. “We [the Seventh-day Adventist Church] do have a statement on the care for the dying; you can find it on our Web site. And in that statement it says that Adventists don’t engage in physician-assisted suicide. But you know, again, we’re very Protestant, and when the central office [world church headquarters] of our church says this … it doesn’t mean, necessarily, that every Seventh-day Adventist [is] going to do it, or not do it, just because the General Conference [world church headquarters] says so.”
He added, “I think the church can provide some very well-crafted statements that can guide people’s thinking. But beyond that, our church does not dictate to its members what they should or should not believe or do.”
According to Niklolaus Satelmajer, associate ministerial secretary for the world church and editor of “Ministry” magazine, a greater emphasis should be placed on palliative care, which offers patients a way to ease suffering at the end of life.
“The biggest danger is can we trust human beings — who have demonstrated amply that they can make bad decisions — to decide about the termination of life,” he asked.
Satelmajer, who has counseled people in the churches he pastored, noted that “emotions can change,” and that a patient who feels assisted suicide might be good at one point could reverse their decision later, even if their condition does not improve.
By noting options for palliative and hospice care, Satelmajer said, pastors can help patients know “there is help available other than assisted suicide.”
In viewing end-of-life issues, Dr. Allan Handysides, physician and health ministries director for the Adventist world church, said it’s important to have a perspective on the source of life itself.
“Life is not ours. Life is God’s and it’s a gift to us. Ethically it should not be our decision to take our own or anyone else’s life,” Handysides told ANN in an interview. “So, technically, I wouldn’t want to be a part of it, but I can understand others wanting to control the time and the manner of their death.”
But while recognizing the free conscience of people in a diverse society, Handysides said Adventist physicians and institutions should not promote or facilitate assisted suicide.
“My recommendation to Adventist institutions is that they would not have anything to do with this at all,” he said. “Not that they would join ranks and make it very difficult for people, but at the same time there is an element of what I consider to be unchristian behavior in that we cannot take life.”
Handysides added, “Our mission is to save life, promote health and do everything in our power to extend life, or permit a person to die in comfort and with dignity, but not to take a step to end life.”
Copyright (c) 2006 by Adventist News Network.
