The following question came from a concerned Baptist: What is Baptist thinking on a person being on a life-support system and the family being asked by the doctor whether to have the life-support turned off? If the person concerned had previously expressed a view on this would the family be bound by that view?
Dr Lachlan Dunjey, the Acting Director of Pathways Counselling, provided the following thoughts.
The medical view on this issue is to uphold the principle of the sanctity of life by seeking to sustain and preserve life where that possibility exists, and is opposed to action to initiate death.
There is sometimes confusion between the issue of euthanasia and the withdrawal of life support. We need to draw a clear distinction between the two. Euthanasia is an interference in the natural process, but ceasing (futile) life-support is a withdrawal of an interference in the natural process. It is misleading to call the latter ‘passive euthanasia’ and I will clarify the issues re definition in a subsequent article.
It is obviously important to know when the life-support is futile i.e. when death is inevitable and imminent. The decision is not always easy - it has been known in the past for life support to be switched off and for the patient to keep on breathing and eventually recover.
Doctors interfere with ‘natural’ processes all the time however this interference is to preserve life where the possibility of recovery exists, and not to hasten death. The preservation of life by life support will continue until such a time as the body’s natural physiological processes can resume life maintenance or until it is deemed that life is no longer - and will not become - sustainable without such support.
In fact, doctors sustain life in many circumstances where support is needed in a specific area but other body functions are preserved e.g. by giving insulin to a diabetic; by assisting breathing in a person with paralysis. The withdrawal of life-support is reserved for cases where such support is deemed futile i.e. where the person is considered to be brain dead by appropriate medical evidence and therefore life is not sustainable.
Practical considerations and examples:
In the event of serious head injury a decision needs to be made as to whether a person being ventilated is ‘brain-dead’ i.e. with no chance of recovery. A rigorous process involving two specialist doctors performing about ten clinical tests at two different times determines this. When this diagnosis is certain then the medical view is that life-support should cease and I believe this to be the right ethical and Christian position i.e. we should not interfere with the process of ‘natural’ death when this is inevitable.
As in the above instance the issue is clear in the event of a serious ‘stroke’ with a definite ‘brain-dead’ diagnosis. But the issue becomes much more complex in the event of a serious stroke possibly just compatible with life and yet holding little recovery of ‘useful’ (a very dangerous concept!) existence. Again, the issues are probably fairly clear in the instance of an elderly person, say 95 years of age, whose partner in life has recently died, who has dementia, is bed-ridden and who has previously expressed a request not to be kept alive! In my view it would be a very uncompassionate thing to keep that person alive by artificial means - with the exception being to allow a close relative to see that person in hospital before death e.g. a child returning from overseas the next day.
At the opposite end of the spectrum may be a young person with a brain haemorrhage due to a congenital abnormality which is capable of surgical correction and where some degree of functional recovery is possible. In this instance it becomes a medical decision to maintain life support to allow the appropriate surgery and then await clarification of the situation with the passage of time.
Most of the time it is clear, in consultation with the doctors concerned, what needs to be done. If there is any doubt, then further consultation should occur.
The above is a personal view and, although representative of Christian doctors, is not to be interpreted as Baptist policy.
Dr Lachlan Dunjey MBBS FRACGP DObstRCOG