biomedical ethics: March 2005 Archives

May the Lord have mercy on her soul


I just heard that Terri Schiavo died. May the Lord have mercy on all of us as well.
Last night on EWTN, I caught the tail end of an old Fr. Groeschel show, when he talked about a legal case where an elderly woman was starved to death in a similar circumstance.
I had this eerie deja vu feeling.
I think that we will see more and more of this with the 'triumph' of the right to die movement.

InfoTheory is a blog I found through a comment on Lilac Rose. He has some fascinating thoughts on the whole situation, form a perspective that I hadn't considered. He also has a sweet trollslap in the comments to his 3/28/05 post.

veritas - quid est veritas?

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The Easter triduum is good for a lot of conversation between me and my husband. You see, we still are in the choir of the parish we joined when we first moved to New Hampshire - even though we now live 15 miles away. We do a lot of talking during the drive. These last few days, as it has become increasingly obvious that Terri Schiavo will be put to death by starvation (barring of course a miracle of divine intervention) this has been the major topic of our conversations. A few themes keep emerging as we consider what is happening. One of the hardest things for both of us to cope with is that what seems to obvious to us seems to be obscured from the view of most of the rest of the world.

We have a couple of major disadvantages should we have desired to remain in ignorance about the whole fiasco. He works in radio, not in any way responsible for or able to have an effect on content, but still a part of the mainstream media. I'll let him speak to how this has affected him. (He blogs very occasionally over at Fathers Know Best).
I work within the chaos that is healthcare in the USA, and have studied (formally and informally) biomedical ethics. In a presentation on biomedical ethics and midwifery that I originally gave in 2000, I observed that the principle of autonomy was running rampant. The dominant model of biomedical ethics in the USA is based upon the ideal of balancing 4 principles - patient autonomy, provider beneficence, provider non-maleficence, and societal justice. Autonomy is basically self-determination. Beneficence is the duty of a health care provider (nurse, physician, pharmacist, etc.) to do good. Non-maleficence is the duty to do no harm. Justice looks at the effect of a medical decision on society as a whole, and includes financial as well as moral considerations. While there are some advantages to looking at decision-making using these concepts, the really big disadvantage is that it is a form of moral relativism. Without an absolute value for good and evil, using these principles to make life and death decisions can be like trying to pay your mortgage with a mixture of real and counterfeit currency.
As Catholic Christians, we have a foundation of absolute values to make use of, and an ethical/philosophical framework (natural law) to interpret these values for use in everyday life, in both ordinary and extraordinary circumstances. But the culture in which we live in the USA does not recognize either the existence of absolute values nor the proper use of the natural law. There is a big difference between 'natural law' and the 'law' that we keep hearing has been properly followed in condemning Terri to a slow death by dehydration.

Among the main contentions of Michael Schiavo is that Terri made the autonomous decision, when she was of sound and whole mind, that she would not want to remain in the situation where her physical sustenance would come through a tube. I recognize that there is (to some of us at least) a bit of a question as to the truth of this contention. But let us, for the sake of discussion, grant that he is indeed accurately rendering a fragment of a conversation from nearly 20 years ago. If we did not as a culture have an unholy admiration for autonomy, it would be obvious that a desire to be allowed to starve to death is not morally right. It violates the natural law, written in our bodies by our Creator, that life is a precious gift and worthy of being sustained.

Beneficence is often interpreted (unfavorably) these days as being patronizing. It brings up images of the elderly physician patting the young woman on her head and saying, "don't you worry your pretty little head about a thing". But that isn't what it is at all. It is taking the responsibility to do what it right, what is moral, what is best for a given individual.
These days,what passes for non-maleficence are the behaviours and choices made in the effort to avoid a malpractice suit. Some of these are worthy for the attempt to provide the highest quality of care, but much of it comes down to CYA documentation and bureaucratic red tape. Independant accrediting agencies like JCAHCO and OSHA have increasingly demanded behavioural changes like taking a 'time out' just as a baby is being born to verify that this is in fact the person the midwife, nurses, doctors, are there to deliver. I know of a low-income clinic who was forced to replace all their rolling stools because the ones they had only had 4 wheels, and the OSHA inspector told them that safety standards demanded 5 wheels.

Justice, which I think was originally intended to see to it that the risk and the poor were provided the same quality of care, has morphed into a kind of utilitarian ethic. Some commenters on Terri's case have made the argument that the $$$$ spent over the last several years to maintain her in the hospice, would have provided much sorely needed health care to others like pregnant moms, infants and children, etc. The argument goes that tube feeding and such care is futile, as it simply prolongs dying at an enormous financial cost. If the tube feeding would enable the person to become a useful member of society, well, that would be a different story.

Without a bedrock of absolute values, the "4 principles" balancing theory of medical ethics goes horribly astray.

Without that bedrock we are left with Pilate's question. And we will continue to sacrifice more innocent disabled persons, in the womb and outside, on the altar of autonomy (or its surrogate, substitutive judgement).
May God have mercy on us all.

from bill luse


goodbye, terri

You are not wood, you are not stones, but men;
And, being men, bearing the will of Caesar,
It will inflame you, it will make you mad:

Please go vote


The Christian Science Monitor has a survey up on Terri Schiavo. Please weigh in here. I am pleased to see that my dh made a brief comment as well.


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Timeline of the culture of deathHow a handful of progressive foundations and quasi-government agencies
set out to provide equitable distribution of health care,
and in the process,
created a duty to die and a culture of death.
And how they hope to secure their legacy . . .
Thanks to Jordan for the link

May God have mercy on us all


addendum and correction


I was in error linking the development of tubal ligation to the Nazis. mea culpa. I try to do thorough fact checking but in this case I accepted the word of a secondary source without double checking.
I found an article on tubal ligation that includes a historical timeline as well as some technical descriptions of the surgery. As you can see from the timeline, it appears that most of the research was done in countries other than Germany:

In 1897, Kehrer and Buettner divided the tubes between the sutures.

In 1898, Ruhl cut the tube 5 cm from the uterus and sutured the ends to a vaginal incision.

In 1898, Rose removed the tubes at the cornua.

In 1919, Madlener crushed and ligated the tubes with nonabsorbable suture.

In 1924, Irving published his method in which the proximal portion of the severed tube is buried in a small myometrial tunnel on the anterior uterine surface.

In 1930, colleagues posthumously published the Pomeroy technique in the New York State Journal of Medicine.

In the 1940s, Hajime Uchida developed his technique, which can be performed as an interval or puerperal procedure. He subsequently reported on his personal experience with more than 20,000 tubal sterilizations over 28 years without a known failure.

In 1936 in Switzerland, Bosch performed the first laparoscopic tubal occlusion as a method for sterilization.

Given what we now know about the Nazis' they probably experimented with these techniques, but they did not seem to have developed any 'pioneering innovations'.

Pulled out of the comments box below


St. Maximilian Kolbe, Patron of Journalists, Patron of prisoners, you were imprisoned for your Christian witness in your secular society and for your Marian Devotion.
You willingly took the place of another and suffered your Martyrdom from starvation.

Intercede with God our Father for our sister Terri. Intercede with God for the
journalists who are reporting on the intended starvation of Terri, that their eyes
may be opened to see this event as the murder of a disabled innoncent. May they also see beyond the lies of those whose authority has been abused in ordering her death. May they be granted the courage to speak their minds and the courage overcome the pressures of our Culture of Death on (and within) the media.

St. Kolbe, intercede with God to comfort Terri in her time of trial. While your
martyrdom was by choice, hers is not. You and Terri are both victims of societies with distorted views of Perfection and of the value of the individual.

May God have mercy on the actions of those within the Legal system of the United States. May the legal system of this country be returned to the values of cherishing each individual. May we view with horror the parallels between the actions of the legal system of the United States of America and that of Nazi Germany. May the suffering of our Parents and Grandparents during "The Second World War" not have been in vain.

May God Bless those in the United States who hold and express Christian values and defend the lives of those who are innocent and can not defend themselves.

We ask this through Christ, our Lord. Amen

Archbishop Chaput speaks out

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From slate


Oy vitae
on stem cells, embryos, and ethics.

Crown of creation?

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I've been listening my way through a 10 CD set of Christopher West expounding on the Pope's Theology of the Body. I keep hearing humanity referenced as the "Crown of Creation". Does anyone know from whence that reference originates? I am sure that it has been around for a while, but the phrase is not to be found in the Bible. Is it used in some of the early Church Fathers? Or maybe some more recent theologians?
Part of what piqued my interest is that I have been thinking about euthanasia, especially of the perinatal sort. It has become so very common in our culture to commit prenatal euthanasia (aborting babies with birth defects) that even many who are otherwise opposed to abortion find nothing objectionable in this. It is often included in the 'hard cases' that also usually include rape, incest, and maternal health issues.

Tough cases make bad law


Should we save mother or child?
Link emailed to me by a friend. Thanks!

Only perfection allowed

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Dawn finds a tale of prenatal diagnosis and tragedy
I am so saddened that parents are being counselled that their only humane choice in these matters is to abort (prematurely end) their pregnancies.
I am saddened that our standards of personhood are approaching those of Gattica.
I grew up reading science fiction dystopias like John Brunner's Stand on Zanzibar, with mandatory genetic testing and abortion/sterilization of 'undesirables'. I never thought it would happen in my lifetime.

Two articles worth keeping


I want to live

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Wonderful 'music video' of the unborn
thanks to my friend nancy for finding this!

Sliding down the slippery slope?


I remember that when Humanae Vitae was first promulgated, there was widespread disbelief that contraception would lead to all the negative social effects Pope Paul VI predicted. There are still a great many compassionate and religious persons out there who honestly believe that the way to prevent abortion is to make contraception widely available.
Here is commentary from a Protestant pro-life leader who lost her job fighting against 'live-birth' abortion. Jill Stanek closes with a challenge to all of us:

Pro-life groups and churches must take greater responsibility for abstinence training and not leave that up to the pregnancy help centers. We must also continue to dialogue about the issue of contraception and make up our minds not let the other side divide us on that.

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About this Archive

This page is a archive of entries in the biomedical ethics category from March 2005.

biomedical ethics: February 2005 is the previous archive.

biomedical ethics: April 2005 is the next archive.

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