Tag: sanctity of life

Bioethics Blogs

 Guest Post: Withdrawing life-prolonging treatment in the patient’s best interests: The implications of Briggs

Guest Post: Jenny Kitzinger, Celia Kitzinger and Jakki Cowley

Paper:  When ‘Sanctity of Life’ and ‘Self-Determination’ clash

In a recent landmark judgment in the Court of Protection (Briggs v Briggs [2016] EWCOP 53), a judge authorised withdrawal of life-prolonging treatment from a minimally conscious patient with potential for further recovery.  Our article in Journal of Medical Ethics addresses the implications of this judgment, highlighting its potential to strengthen compliance with the Mental Capacity Act 2005, and the delivery of person-centred care.

How this will work in practice is another question.

We have supported families (CK and JK) and represented patients (JC) in a series of cases – several of which have reached court – in which families sought treatment withdrawal and doctors refused.  We know many families who believe that their brain-injured relative would not want to receive on-going life-prolonging interventions.  It usually takes years for families to come to this view and even longer to communicate it to doctors. Some health care professionals can be dismissive – or even hostile – when families speak up.   Even when doctors acknowledge that a patient will never regain consciousness, some have ethical objections to withdrawing treatment from a clinically stable patient.  It feels, they say, like ‘euthanasia’.

An ethical imperative to give treatment is experienced even more acutely, by some doctors, when the patient may make some degree of ‘progress’ – perhaps recovering consciousness and the ability to interact with others.  The treating clinician in the Briggs case was firmly of the view that it would be unethical to withdraw treatment from a patient whose level of consciousness might improve over time. 

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics Blogs

Mailbag

Brief comments on four short articles from this week, on disparate topics:

James Capretta of the American Enterprise Institute (meaning he is politically right of center) pleads in the Journal of the American Medical Association (JAMA) for compromise between Republicans and Democrats on further healthcare policy reform.  Arguing that the House-passed American Health Care Act (AHCA) may never pass, he believes that a better result politically and for public policy would be if legislators could, in essence, split the difference between the AHCA and current law, the Affordable Care Act (ACA, aka “Obamacare”) on some points where he sees some agreements in principle.  He proposes: 1) a hybrid approach between the ACA’s income-based tax credits for health insurance purchase and the AHCA’s age-based approach; 2) ensuring continuous insurance coverage for people with pre-existing conditions by modifying the ACA’s penalties for not being insured to fall more heavily on higher-income people; 3) setting limits on the favorable tax treatment of employer-paid health insurance premiums; 4) automatically enrolling uninsured people into a bare-bones, no-premium plan from which they could opt out in favor of re-enrollment in a different plan (a proposal that sounds to me a lot like the Democrats’ “public option” with a guaranteed fight over scope of coverage); and 5) limiting Medicaid expansion to tie it to reform of the program (something that sounds to me a lot like what I understand is currently in the AHCA).  Mr. Capretta knows a lot more about health policy than I, and has been at it a lot longer. 

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics Blogs

Bishop Tutu’s Plea Prompts Personal Meditation on Assisted Suicide

By Myra Christopher
I worked late Tuesday night and was listening to NPR as I always do during my short commute home when I heard that, in celebration of his 85thbirthday, Bishop Desmond Tutu announced that he supports physician-assisted suicide and “prays that politicians, lawmakers and religious leaders have the courage to support the choices that terminally ill citizens make in departing Mother Earth with dignity and love.” I was stunned.
At age 30, I decided to spend my life working to improve end-of-life care and that the way that I would do that would be by “doing ethics.” I would spend my life arguing that the seriously ill and dying have an inherent right to a “dignified death.” This year I will be 70, and I have had a long and interesting career. Over the past 40 years, the issues of euthanasia and physician-assisted suicide have been what I considered as recurring distractions from what I have thought to be really important, i.e., advancing palliative care. Bishop Tutu’s comments, however, cannot and should not be considered by any one as simply a “distraction.” I believe they are a “game-changer.”
In the late 1990s, I directed Community-State Partnerships to Improve End-of-Life Care, an $11.25m Robert Wood Johnson (RWJ) Foundation grant award program. At about the same time, Jack Kevorkian – or Dr. Death as he came to be known – came on to the public scene. At a national conference, I was asked what I thought of Dr. Kevorkian, and I said without hesitating that I thought he was a murderer and should be imprisoned.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics Blogs

Religious exemptions to assisted dying harm patients

Stuart Chambers argues that faith-based institutions should not be ‘conscientiously objecting’ to medical assistance in dying.

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Since the passing of Bill C-14 “An Act to amend the Criminal Code and to make related amendments to other Acts (medical assistance in dying),” the debate over negative and positive rights has resurfaced. Assisted dying advocates emphasize negative rights. They insist that the state should refrain from interfering in the intimate personal decisions of its citizens. However, they also make claims about positive rights insofar as the state has an obligation to provide the resources—hospitals, staff, drugs—required to fulfill a dignified death. Without both types of rights — negative and positive — the Act is groundless. When faith-based hospitals demand religious exemptions from medical assistance in dying, they are, thereby, undermining personal dignity. The result is increased vulnerability and suffering for patients.

For reasons of conscience, individual health care professionals may refrain from providing end-of-life services. There is nothing in the Act, however, that remotely suggests that publicly-funded hospitals are exempt from the responsibility to provide medical assistance in dying.  This has not stopped faith-based institutions from imposing their theological worldview on their patients. In December 2015, the Catholic Health Sponsors of Ontario rejected any exception for physician-assisted death in its institutions and would not “directly or explicitly” refer a patient to get the medical procedure elsewhere.

Concordia Hospital

This religious bias, however, was not in sync with the attitudes of Ontarians. When polled in October 2016, 57% of Ontario residents disapproved of the position of Catholic hospitals on medical assistance in dying.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics News

The battle continues over the A-List embryos

In happier times   

What began as soap opera is turning into a master class in metaphysics. “Modern Families” TV star Sofia Vergara, 44, and her former partner, entrepreneur and Hollywood producer Nick Loeb, 41, have been at war over two frozen embryos in a California IVF clinic. Vergara, now married to “True Blood” star Joe Manganiello, refuses to allow the embryos to be brought to term with a surrogate mother; Loeb insists that they have a right to life.

Both of them have deep pockets and wily lawyers. With 600,000 supernumerary embryos in deep freeze in the US, the outcome could set legal precedents in a number of areas. However, the dispute is not theoretical, but passionate and sometimes vindictive.  

The latest moves are as follows.

Slut-shaming

In mid-November Vergara’s lawyers demanded that Loeb disclose the names of two former girl friends who had abortions. They want to show that his belief that life begins at conception is insincere. “Oddly, Loeb wants us to believe that he supports a woman’s right to privacy, and to make a choice concerning reproduction. However, he seems to believe that his celebrity ex-fiancé, Sofia Vergara, does not have those same rights,” said her lawyer.

Loeb, who now has strong pro-life views, was adamant in his refusal. “Could you imagine if you had moved on with your life, gotten married and had children and kept this a secret from your family, then all of a sudden 15 years later (you were) made to reveal your abortion to the world.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics News

Is “sanctity of life” a useful concept?

In increasingly heated debates over abortion and euthanasia, pro-lifers cling doggedly to the concept of “the sanctity of life”. This has been under attack for years by utilitarian philosophers, notably Princeton’s Peter Singer. In a 2005 article Singer went so far as to contend that “During the next 35 years, the traditional view of the sanctity of human life will collapse under pressure from scientific, technological, and demographic developments. By 2040, it may be that only a rump of hard-core, know-nothing religious fundamentalists will defend the view that every human life, from conception to death, is sacrosanct.”

You might think that Singer’s withering prediction would be countered with a robust defence by Catholic bioethicists. However, in a controversial article in The New Bioethics, David Albert Jones, director of the Anscombe Bioethics Centre, in the UK, suggests that the term “sanctity of life” is so woolly that it should be scrapped. He says that Singer and others are attacking a straw man created by his buddies. “The connotations of this language are part of a deliberate attempt to distract from fundamental issues of justice, solidarity and human rights and falsely to imply that the legal protection which is due to vulnerable human beings is based only on religious sentiment.”

In a very interesting analysis of the term, Jones points out that Christian philosophers and theologians almost never used the term until the 1970s. It was only with the publication in 1957 of a book by Welsh legal scholar Glanville Williams, The Sanctity of Life and the Criminal Law, that it gained currency.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics News

Sanctity of life

In 2005 Peter Singer confidently forecast the demise of the “sanctity of life” by 2040. His objections to the idea were mainly philosophical, but he cited two piece of evidence. One was the amazing success of a South Korean scientist named Hwang Woo-suk in creating embryonic stem cell lines. The other was the continuing advance of legal assisted suicide and euthanasia. 

Within months, Hwang Woo-suk was exposed as one of the greatest scientific frauds of the last century. As for euthanasia, Singer could still be right (although fears do persist that it could become, in his words, a “holocaust)”. One out of two is not an impressive result and does little to inspire confidence in his prediction. 

But there is another problem with Singer’s critique of the sanctity of life argument, as we report this week. A British bioethicist, David Albert Jones, director of the Anscombe Bioethics Centre, points out that it was not Christians who “invented” the sanctity of life, but Singer and his cronies. In a very thought-provoking article in The New Bioethics, he says that “sanctity of life” is just a straw man set up to label discredit arguments against Singer’s “quality of life” approach. It is a controversial thesis which deserves to be debated. 

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics News

Nobel laureate Desmond Tutu backs assisted suicide in District of Columbia

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Overlooked in the ghastly spectacle of America’s I-can-dig-up-more-dirt-than-you-can election is a campaign in Washington DC to legalise assisted suicide. The issue goes to a vote on Monday in a full meeting of the District of Columbia Council.

Supporters of the measure have scored a public relations coup by enlisting Nobel Peace Prize laureate, a hero of the struggle against apartheid, Desmond Tutu, who is also an Anglican archbishop. Although Tutu reversed his opposition to aid-in-dying in 2014, he declined at the time to say whether he would take advantage of it himself.

Now, just ahead of the vote in the Council, he has published an op-ed in the Washington Post in which he urges voters to legalise assisted suicide, as Canada and California have already done. His essay has been reinforced with a YouTube video made by the assisted suicide lobby group Compassion & Choices.

C&C has recruited a number of prominent clerics, although their Christianity tends to be unconventional. One, for instance, is Episcopalian Bishop John Shelby Spong, who dissents from mainstream Christian beliefs like the existence of God. There seems to be significant level of support within the Anglican Church for assisted suicide. The former Archbishop of Canterbury, Lord Carey, has declared that it would be “profoundly Christian and moral”. Tutu says in his op-ed:

“I believe in the sanctity of life. I know that we will all die and that death is a part of life. Terminally ill people have control over their lives, so why should they be refused control over their deaths?

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics Blogs

Thruple Babies: Born of 3 Parents

by Craig Klugman, Ph.D.

If a thruple is a three-person relationship, then would their combined genetic child be a thruby?

A baby boy born in April  is believed to be the first child created from the DNA of three parents: mother, father, and egg donor using the spindle nuclear transfer technique. Despite the claims of the media, this is not the first child born with three genetic parents.

Mrs. Y is a carrier of the genetic mutation for Leigh syndrome, is a fatal neurological disease usually diagnosed in a child’s first year. The gene for the disease resides in the 37 genes of the mitochondrial DNA of the cell. The mitochondria live in the cell, but outside of the nucleus that houses most of an organism’s DNA (another 20,000 genes). Mitochondria and their DNA are always inherited from the mother.

After 4 miscarriages and two children dying of Leigh syndrome, Mrs. Y sought the help of John Zhang, and infertility specialist in New York. If the problem was the mitochondrial DNA, the solution would be to use a donor’s egg (for cytoplasm and mitochondria) and exchanging the donor egg’s nucleus for the nucleus from one of Mrs. Y’s oocytes. This is a process called spindle nuclear transfer. Then the father’s sperm is used to fertilize the hybrid egg. This way the child would have both the mother and father’s DNA, but the mitochondrial DNA comes from a third source, the egg donor.

If this sounds familiar, that’s because in February, the United Kingdom announced ethical and legal approval for creating three-person embryos.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics News

Interview: Dissecting the age of ‘do harm’ medicine

Wesley J. Smith is one of America’s leading commentators on bioethical issues, especially assisted suicide and euthanasia. His columns are published in the National Review and he is the author of 14 books. BioEdge interviewed him about his latest, Culture of Death: The Age of “Do Harm” Medicine.

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BioEdge: This is a thoroughly revised edition of a book you published 16 years ago. In your view, is there less respect for life in American medical culture now? Are there any bright spots?

Wesley J. Smith: There is less respect for human equality and the sanctity of life in healthcare generally, I fear, and not only in the U.S. Indeed, I changed the subtitle of the book to “The Age of ‘Do Harm’ Medicine” because it now grapples with developments outside the United States as well as in my own country. We are all connected, so that what happens in Canada impacts Australia, what happens in the USA can have a pull on South Africa.

I have observed in the 15 years since the first edition of Culture of Death, that throughout the developed world and the West we see a terrible and increasing disrespect for the intrinsic value of the most weak and vulnerable among us. Euthanasia has spread like a stain and grown increasingly toxic. For example, in Belgium medicalized killing is now coupled with organ harvesting—including of the mentally ill. Health care rationing, which is blatant and invidious medical discrimination, is a growing threat. Advocacy continues to discard the dead donor rule in organ transplant medicine, even proposals for the live-harvesting of patients with profound cognitive disabilities.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.