End-of-Life Decisions of a Patient with Sclerosis Case Study

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Abstract

When in pain or affected by a terminal illness, people often consider putting an end to their sufferings in any possible way. Euthanasia is one of the available methods in some cases, although this instrument is still highly debatable. For instance, even within the Christian perspective, which is associated with the idea of every life sacredness, two opposing views exist. On the one hand, euthanasia seems to be a sin and inappropriate method under any circumstances. On the other hand, some Christians admit that suffering and some health conditions can be a justification for euthanasia. The choice may depend on the angle to analyze the issue. For instance, those making end-of-life decisions may consider such aspects as fallenness of the world, the hope of resurrection, major Christian values, as well as people’s free will and cognition. George, who is diagnosed with amyotrophic sclerosis (ALS) and will have to face a rapid and dramatic deterioration of his health, is an illustration of the cases when euthanasia is justified.

Introduction

Palliative care is associated with one of the most challenging work environments as patients are exposed to pain and suffering due to their chronic conditions. At that, nursing professionals involved in other clinical settings may also need to consider issues related to end-of-life decisions. The Christian perspective has been long characterized by a strict and direct dogma regarding people’s life and death choices. However, Jones (2016) states that the debate regarding the matter has led to the appearance of two views even within the scope of the Christian tradition. In terms of the Christian worldview, such end-of-life decisions as euthanasia can be regarded as unacceptable, but they can still be possible under some circumstances, as seen by some Christians. However, the supporters of both views agree on one thing as they believe that every person (as opposed to a group of people (family) or society) is responsible for this kind of choice. The present paper includes an analysis of George’s case with a focus on the Christian worldview.

Suffering and the Fallenness of the World

George will have to go through a long period of suffering due to his health deterioration. Although he feels strong and healthy in his 50s, he will soon lose his ability to address his basic needs, including eating and even breathing. Amyotrophic sclerosis (ALS) is associated with physical pain, as well as mental and emotional suffering. From many perspectives, this situation may seem unfair and cruel, but it may make sense in terms of the Christian view.

The fallenness of the world is one of the central ideas within the scope of the Christian picture of the world. With an emphasis on this aspect, George would see his suffering as a part of human existence that is made of pleasure, happiness, as well as pain and suffering. The Christian view of the world acknowledges its complexity, and such negative phenomena as suffering are regarded as another facet of human existence (Devettere, 2016). Therefore, people accept pain as an unfortunate given and try to focus on the pleasant or meaningful side of their being. The entire world is imperfect, and pain is one of these imperfections, so it has to be tolerated. George would also see his pain as a fact of life that has to be accepted. Of course, the man can question whether it is fair and contemplate the power of his faith. However, he would tolerate his suffering if he concentrates on pain as a manifestation of the fallenness of the world.

Suffering and the Hope of Resurrection

Regarding the positive facet of the world, the hope of resurrection is one of these pillars keeping Christians optimistic and patient. According to the Christian perspective, every person will rejoice with God after death, which makes a living and even suffering meaningful (Devettere, 2016). Hope is one of the spiritual remedies that can help people endure pain as patients’ faith gives them strength and courage to live through really difficult periods.

George would also be able to find the force to cope with his health condition if he focused on the hope of resurrection. He would consider his present situation as a necessary stage before becoming a part of something bigger. If the man contemplated rejoicing with God, he would see that even the suffering caused by his disorder is meaningless and worthless. He would also think about the torture Jesus had to go through before he also became a part of something bigger when he rejoiced his Father. Of course, George would still feel pain and could have very dark emotions and ideas, but he would still be able to reconcile with himself if he had hope.

Health and Value of a Person’s Life

It is also noteworthy that such health conditions as ALS have a substantial impact on patients’ quality of life, in addition to causing pain. George has to think of the days when he would be unable to walk, move, swallow, and even breathe, which can make him think of the worth of his life. For many people, such conditions make individuals less of a human, which raises various ethical dilemmas (Singh, 2014). For instance, the existence of such people can seem less relevant compared to others, and it can be difficult to identify the line between a living and a dead person under similar consequences.

From the Christian perspective, however, every life is sacred and priceless. Irrespective of some disabilities, every human being is a holder of the divine, so the worth of all people’s lives can never be questioned (Devettere, 2016). Christians’ beliefs are rooted in the idea that they are creations of God with their own missions and paths. Therefore, every health condition has its purpose and makes human existence meaningful. Therefore, if George viewed his ALS period in terms of the Christian paradigm, he would not place a smaller value on his life. He would try to find the purpose and higher aim of his state, which would help him in tolerating the physical, mental, and emotional suffering associated with the disease.

Values and Considerations Regarding Euthanasia

George is fearful of his future life due to his diagnosis, and he even opts for euthanasia, at least, at some period. From the Christian perspective, he would consider several values and aspects. On the one hand, he would think about the sacred nature of human life and its unquestionable worth, which are basic tenets of Christianity (Devettere, 2016). All people are God’s children. He loves and cherishes, so even an ill person is equally important for God. Besides, George would regard pain as a part of human existence or even a necessary stage before rejoicing with the divine. George would think of the higher aim of his existence that was assigned by God. Clearly, one of the major Christian beliefs is associated with God’s plan that can never be ignored or changed (Jones, 2016). Thus, any form of suicide (such as euthanasia) is regarded as a sin as an individual puts an end to their existence.

On the other hand, George would also contemplate the greatest gift God gave to His children, which is free will and cognition. People were granted the ability to think, analyze, and create, which made them capable of advancing sciences and improving their lives. Although some Christians of the past were against science and its breakthroughs during the darkest ages, now it is regarded as a part of modern life and an illustration of the divine core in people (Jones, 2016). Taking drugs to relieve pain is an appropriate action as God wants that humans were active in improving their own lives.

Sacrifice is another characteristic feature of the Christian view as giving for the sake of others is a virtue (De Villiers, 2016). Therefore, George would think that ending his life would be a sacrifice to stop his close one’s sufferings as they would see him in pain and would have to witness his never-ending torture. It is also necessary to add that George would consider the fallenness of the world and the hope of resurrection, which will make him think of his own life and its value. George would be able to undergo a serious trial analyzing his past and making the corresponding conclusions. These thoughts would help him find the meaning of his suffering as well as his choice.

Morally Justified Options for George

Based on the abovementioned options, it is possible to note that George could opt for euthanasia at a certain point. He could make the decision to end his life when he can no longer move and breathe with no hope for improvement. He would exercise his right to make this sacrifice and, at the same time, to use his free will and decide for himself. Of course, as a Christian, he would hope that an effective cure is created or suggested treatment would enable him to live longer or die with dignity. Being a Christian, George would also tolerate his pain and focus on the positive aspects of his life. He would find courage and strength in communicating with his family, friends, and community, as well as his inner dialogue with God.

Although all life is sacred and humans are a part of God’s major plan, there are situations when patients can make hard decisions regarding their life and death (De Villiers, 2016). People were given the mind to decide what can be appropriate and beneficial for them as humans. Of course, they cannot attempt suicide, which is a sin, but when a person becomes absolutely motionless and has to go through unbearable pain, it is their right to make the decision to end such existence. At the same time, it can be beneficial for patients such as George to address their spiritual leaders who could guide them on their way to a difficult decision. George has to be completely sure he is not making a mistake as it may cause more distress at some period of his illness. George would also benefit from the emotional support of the family, community, and especially the healthcare staff, who can be more knowledgeable in certain aspects regarding the procedure.

Personal Perspective

I would have similar emotions and ideas in George’s situation that is associated with one of many people’s deepest fear of losing control and independence. Based on my worldview, I would also try to find an opportunity for voluntary euthanasia. I would try to sign the corresponding papers where all relevant points are highlighted so that my close ones did not have to make difficult decisions. Of course, I would undergo treatment and try experimental methods, and I would probably mention that a certain period of time before the end of life should pass. I would hope some effective treatment would emerge during this period, and I could be cured. However, I would still want to exercise my right and decide for myself. My physical pain would be intensified as I would see my family’s sufferings. Although I am a Christian (not that devout but still), I believe people are given cognition and free will, so they should be able to enjoy their right to remain free, even if it means being free from one’s own body.

Conclusion

On balance, it is necessary to note that end-of-life decisions are always hard to make and even discuss. People have diverse views on the matter based on their beliefs and backgrounds. The Christian worldview is associated with patience, resignation, and faith. Christians find reconciliation with their own selves through prayers and sharing their sorrow with their close ones. They find the strength to face the suffering and pain in communicating with people they love and with God. However, euthanasia is also an acceptable option for people following Christian doctrines in some severe cases. Healthcare professionals should always consider this when interacting with patients, especially those who are terminally ill.

References

Devettere, R. J. (2016). Practical decision making in health care ethics: Cases, concepts, and the virtue of prudence (4th ed.). Washington, DC: Georgetown University Press.

De Villiers, D. E. (2016). HTS Teologiese Studies / Theological Studies, 72(4). Web.

Jones, D. A. (2016). Apostles of suicide: Theological precedent for Christian support of ‘assisted dying’. Studies in Christian Ethics, 29(3), 331-338. Web.

Singh, M. (2014). Web.

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